Kim Y Y, Cho S H, Kim W K, Park J K, Song S H, Kim Y K, Jee Y K, Ha M N, Ahn Y O, Lee S I, Min K U
Department of Internal Medicine, Seoul National University College of Medicine, Korea.
Clin Exp Allergy. 1997 Jul;27(7):761-8. doi: 10.1046/j.1365-2222.1997.710839.x.
In most epidemiological survey studies, only subjective symptoms and past medical history of asthma have been used as diagnostic criteria. Even though a questionnaire survey can be performed in a large population study at low cost, limitations such as lack of objectivity and poor predictability in non-specific bronchial hyperresponsiveness cannot be avoided.
The purpose of this study was to elucidate the prevalence of current asthma based on questionnaires and methacholine bronchial provocation test, and the prevalence of atopy in Korea.
We performed modified ATS respiratory questionnaires and allergen skin-prick test with 10 common inhalant allergens among 3219 subjects aged 7-19 years in Seoul and a rural part of a small city, Chungju in Korea. Methacholine bronchial provocation tests were also performed among those who had asthma symptoms according to the questionnaire. The criteria of asthma was presence of both asthma symptoms and non-specific bronchial hyperresponsiveness. Atopy was defined as when an allergen induced weal size is same or larger than that caused by histamine.
The prevalence of asthma based on questionnaires and methacholine bronchial provocation tests was 4.6%, while the prevalence of wheeze was 8.2% and 19.3% of total population complained of one or more respiratory symptoms related to asthma on the questionnaires. There was no significant difference according to age, sex and living area. The mean prevalence of atopy was 35.0% and the most common allergens were Dermatophagoides farinae (30.9%), Dermatophagoides pteronyssinus (27.5%), cat fur (20.4%) and cockroach (11.8%). The atopy prevalence in Chungju area was higher than that in Seoul and males showed a higher prevalence than females. The asthma prevalence was higher among atopics (6.8%) than among non-atopics (2.7%). None of questionnaire items were enough to predict the presence of bronchial hyperresponsiveness in terms of sensitivity, specificity and positive predictive value.
The prevalence rate of current asthma in Korea was 4.6% and the prevalence rate of atopy in Korea was 35.0%. Questionnaire-based surveys are not enough to predict the actual prevalence of asthma.
在大多数流行病学调查研究中，仅将哮喘的主观症状和既往病史用作诊断标准。尽管问卷调查可在大规模人群研究中低成本开展，但诸如缺乏客观性以及非特异性支气管高反应性预测性差等局限性仍无法避免。
本研究旨在基于问卷调查和乙酰甲胆碱支气管激发试验阐明韩国当前哮喘的患病率以及特应性疾病的患病率。
我们对韩国首尔及小城市忠州农村地区的3219名7至19岁受试者进行了改良的美国胸科学会（ATS）呼吸问卷及10种常见吸入性变应原的变应原皮肤点刺试验。还对根据问卷有哮喘症状的受试者进行了乙酰甲胆碱支气管激发试验。哮喘的标准为同时存在哮喘症状和非特异性支气管高反应性。特应性疾病定义为变应原诱发的风团大小等于或大于组胺诱发的风团大小。
基于问卷调查和乙酰甲胆碱支气管激发试验的哮喘患病率为4.6%，而喘息患病率为8.2%，19.3%的总人口在问卷中主诉有一项或多项与哮喘相关的呼吸道症状。按年龄、性别和居住地区无显著差异。特应性疾病的平均患病率为35.0%，最常见的变应原为粉尘螨（30.9%）、屋尘螨（27.5%）、猫毛（20.4%）和蟑螂（11.8%）。忠州地区的特应性疾病患病率高于首尔，男性患病率高于女性。特应性疾病患者中的哮喘患病率（6.8%）高于非特应性疾病患者（2.7%）。就敏感性、特异性和阳性预测值而言，没有一项问卷项目足以预测支气管高反应性的存在。
韩国当前哮喘的患病率为4.6%，特应性疾病的患病率为35.0%。基于问卷的调查不足以预测哮喘的实际患病率。
