2000年至2010年昆明市儿童哮喘流行病学调查结果比较
Comparative Analysis of 2000~2010 Epidemiological Survey of Childhood Asthma in Kunming City, China
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摘要: [摘要]目的 了解2000年至2010年之间昆明市儿童哮喘流行情况、分布特征、诱发因素及治疗情况的变化,为进一步改进哮喘患儿诊治方案提供依据.方法 采用随机整群抽样的方法,通过自填式问卷调查与集中调查相结合的方式进行调查,对2000年和2010年两次哮喘流行病学调查的初筛问卷中的可疑哮喘患儿按哮喘诊断标准进行诊断,对确诊的哮喘患儿填写哮喘儿童调查表.建立问卷数据库,并对2次调查的数据进行整理、分析.结果 2010年昆明市0~14岁儿童哮喘患病率为1.40%(150/10 717),较2000年的0.88%(92/10 426)有明显增高(χ2=12.52,P<0.05).与2000年相比,哮喘患儿既往诊断与调查时最后诊断的符合率由22.8%提高到了51.3%(χ2=19.23,P<0.05),哮喘急性发作的比例由40.2%下降到了19.3%(χ2=12.54,P<0.05,抗生素的使用率由97.8%下降到了80.0%(χ2=14.28,P<0.05),吸入激素治疗比例由12.0%上升到了64.0%(χ2=60.53,P<0.05=.结论 昆明市0~14岁儿童哮喘患病率较10 a前有明显增加,哮喘既往诊断与调查时最后诊断的符合率有所提高,哮喘急性发作率有所下降,抗生素使用比例下降,而吸入糖皮质激素比例有所上升.但仍需大力推广“儿童支气管哮喘诊断与防治指南”,以进一步降低哮喘患儿的漏诊率、规范使用糖皮质激素及支气管舒张剂吸入治疗及减少抗生素的使用比例.Abstract: [Abstract]Objectives To investigate the prevalence of childhood asthma in 2000~2010, to find the changes of childhood asthma in distribution characteristics, precipitating factors, diagnosis and treatment status, and to provide scientific data for the improvement of the prevention and management of asthma in children in Kunming city,China. Methods Children were selected by random cluster sampling. Standardized preliminary questionnaire was used for screening out possible patients in the two surveys of 2000 and 2010. Diagnosis of asthma was confirmed by diagnostic criteria in suspected asthmatic children. Asthmatic children were further asked for past diagnosis and treatment with the questionnaire of asthma in children. Double entry and validation were adopted for all data and analysis was carried out using Epi-Info software. Results Compared with 2000,the total asthma incidence rate increased significantly from 0.88% to 1.40%(χ2=12.52,P<0.05), the coincidence rate of final diagnosis and previous diagnosis increased from 22.8% to 51.3%(χ2=19.23,P<0.05)and the proportion of acute exacerbation of asthma reduced from 40.2% to 19.3%(χ2=12.54,P<0.05)in 2010. Compared with 2000,Antibiotics use rate reduced from 97.8% to 80.0%(χ2=14.28,P<0.05)and the proportion of inhaled corticosteroid increased from 12.0% to 64.0%(χ2=60.53,P<0.05). Conclusion Compared with 10 years ago,the total asthma incidence of childhood asthma aged 0~14 year old in Kunming city was significantly increased. The coincidence rate of final diagnosis and previous diagnosis increased and the proportion of acute exacerbation of asthma reduced. Antibiotics use rate reduced and the proportion of inhaled corticosteroid increased. The treatment and management of asthma in children awaits improvement as well, especially in reducing the rate of missed diagnosis in children with asthma and regulating the use of corticosteroids and bronchodilators inhaling treatment and reduces the use of the proportion of antibiotics.
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