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哮喘药物使用中的性别差异:横断面研究

Sex differences in the use of asthma drugs: cross sectional study.

作者信息

Sexton M, Althuis M D, Santanello N, Hyndman S, Williams R, Schmeidler D

机构信息

Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore 21201, USA.

出版信息

BMJ. 1998 Nov 21;317(7170):1434-7. doi: 10.1136/bmj.317.7170.1434.

Abstract

OBJECTIVES

To assess the use of asthma drugs by men and women with asthma and to identify sex specific predictors for the use of oral steroids.

DESIGN

Cross sectional study.

SETTING

Six general practices in East Anglia.

SUBJECTS

103 men and 134 women aged 20-54 with asthma.

MAIN OUTCOME MEASURES

Self reported use of agonists, inhaled steroids, and oral steroids.

RESULTS

No sex difference was found in use of agonists or inhaled steroids. However a strong association existed between sex and oral steroid use. 40 (30%) women reported using oral steroids compared with nine (9%) men. Women were more than five times (odds ratio=5.5, 95% confidence interval 2.2 to 13.7) more likely to report use of oral steroids than men after asthma symptoms, age, visits to the general practitioner in previous six months, and time since diagnosis of asthma were controlled for. Women who had visited the general practitioner for asthma one or more times in the previous six months were four times (3.9, 1.6 to 9.5) as likely to report use of oral steroids. In addition, more frequent visits to the general practitioner for asthma were related in a dose-response manner to a greater likelihood of using oral steroids among women after asthma symptoms, age, and time since diagnosis were controlled for. This relation was not observed among men.

CONCLUSION

Women used oral steroids more than men. The more frequent consultations with a doctor by women may result in more requests for oral steroids or doctors may preferentially prescribe oral steroids to women.

摘要

目的

评估哮喘男性和女性患者哮喘药物的使用情况,并确定口服类固醇使用的性别特异性预测因素。

设计

横断面研究。

地点

东安格利亚的六个普通诊所。

研究对象

103名年龄在20 - 54岁之间的哮喘男性患者和134名哮喘女性患者。

主要观察指标

自我报告的激动剂、吸入性类固醇和口服类固醇的使用情况。

结果

在激动剂或吸入性类固醇的使用方面未发现性别差异。然而,性别与口服类固醇的使用之间存在密切关联。40名(30%)女性报告使用口服类固醇,而男性为9名(9%)。在控制哮喘症状、年龄、过去六个月内看全科医生的次数以及哮喘诊断后的时间后,女性报告使用口服类固醇的可能性是男性的五倍多(比值比 = 5.5,95%置信区间2.2至13.7)。在过去六个月内因哮喘看过全科医生一次或多次的女性,报告使用口服类固醇的可能性是男性的四倍(3.9,1.6至9.5)。此外,在控制哮喘症状、年龄和诊断后的时间后,女性因哮喘更频繁地看全科医生与使用口服类固醇的可能性增加呈剂量反应关系。在男性中未观察到这种关系。

结论

女性比男性更多地使用口服类固醇。女性更频繁地咨询医生可能导致更多的口服类固醇使用请求,或者医生可能更倾向于给女性开口服类固醇。

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