Speizer F E, Doll R, Heaf P
Br Med J. 1968 Feb 10;1(5588):335-9. doi: 10.1136/bmj.1.5588.335.
The mortality attributed to asthma has increased annually in England and Wales from 1960 to 1965. The increase is more pronounced at ages 5 to 34 years than at older ages and is most pronounced at ages 10 to 14 years. In this last age group the mortality increased nearly eight times in seven years, and in 1966 asthma accounted for 7% of all deaths. No comparable increase has been observed in any other country, but smaller increases at ages 10 to 19 years have been observed in Australasia, Japan, western Europe, and the United States. There is no evidence to suggest that there has been any change in diagnostic habits, certification of deaths, or methods of classification which could account for the increase in Great Britain, and it is concluded that the increase is real. General practitioners' records provide no evidence of an increase in prevalence and it seems probable that there has been an increase in case fatality. No environmental hazards are known which could have increased the severity of the disease, and the possibility has to be considered that the increase may be due to new methods of treatment. Corticosteroids have been used increasingly since 1952, and in Great Britain the use of pressurized aerosols containing sympathomimetics has increased rapidly since 1960.
1960年至1965年期间,英格兰和威尔士因哮喘导致的死亡率逐年上升。5至34岁年龄段的死亡率上升比年长年龄段更为明显,其中10至14岁年龄段最为显著。在这个年龄段,死亡率在七年内增长了近八倍,1966年哮喘导致的死亡占所有死亡人数的7%。其他国家均未观察到类似的增长情况,但在澳大拉西亚、日本、西欧和美国,10至19岁年龄段有较小幅度的增长。没有证据表明诊断习惯、死亡证明或分类方法发生了任何变化,而这可以解释英国的死亡率上升情况,因此得出结论,这种增长是真实的。全科医生的记录没有显示患病率上升的迹象,似乎很可能是病死率有所上升。目前尚未发现任何可能增加疾病严重程度的环境危害因素,因此必须考虑到死亡率上升可能是由于新的治疗方法导致的。自1952年以来,皮质类固醇的使用越来越多,在英国,自1960年以来,含有拟交感神经药的加压气雾剂的使用迅速增加。