Cadet B, Robine J M, Leibovici D
INSERM Equipe Démographie et Santé, Hôpital Lapeyronie, Montpellier.
Rev Epidemiol Sante Publique. 1993;41(5):363-73.
In recent years disconcerting observations have been published concerning changes in mortality from asthma in France and other countries. These conclusions are difficult to assess due to uncertainty regarding the underlying asthma mortality trends. We have attempted to address this question by constituting a statistical series of asthma deaths from 1925 to 1989. The 1925 to 1989 mortality trend is clearly decreasing. This decrease follows the same rhythm as the general mortality decline, since the proportion of asthma in total deaths remained between 3 to 4/1000. Three periods are emphasized: from 1925 to 1965 where the decreasing trend is interrupted by an important crisis in mortality, from 1965 to 1980 where the decrease is regular, and the last period since 1980 with an important crisis in 1985 and 1986; crisis applying to all genders and ages. The latest trend is uncertain. Careful epidemiologic surveillance will decide between a change in the secular trend or a transitory crisis and thus determine the cause(s). An effect due to the reinclusion by ICD 9 of a fluctuating component in asthma mortality cannot be excluded.
近年来，有关法国及其他国家哮喘死亡率变化的令人不安的观察结果已发表。由于潜在哮喘死亡率趋势的不确定性，这些结论难以评估。我们试图通过构建1925年至1989年哮喘死亡的统计系列来解决这个问题。1925年至1989年的死亡率趋势明显下降。这种下降与总体死亡率下降的节奏相同，因为哮喘在总死亡人数中的比例保持在千分之三至四之间。强调了三个时期：1925年至1965年，死亡率下降趋势被一次重要的死亡率危机打断；1965年至1980年，下降趋势较为规律；1980年以来的最后一个时期，1985年和1986年出现了一次重要危机；该危机适用于所有性别和年龄。最新趋势尚不确定。仔细的流行病学监测将在长期趋势变化或短暂危机之间做出判断，从而确定原因。不能排除国际疾病分类第九版（ICD 9）将波动成分重新纳入哮喘死亡率所产生的影响。
