哮喘的缓解：一项北欧的纵向研究（RHINE研究）
2008/02/05
为了调查在普通成人哮喘患者缓解率与年龄、性别、哮喘症状、过敏性鼻炎和吸烟的关系，1999～2001年Hilm等对北欧地区参加欧洲社区呼吸健康调查而且确诊为哮喘的1153例患者进行随访问卷调查。研究对象基本情况的调查在欧洲社区呼吸健康调查第一阶段完成。哮喘缓解的定义为：连续2年没有哮喘症状，目前也未使用哮喘药物。缓解率以“例数/千人年”表示，并以cox回归模型估计风险率(HR)。
调查发现，随访哮喘患者的平均缓解率为20.2/千人年。男性和女性的缓解率分别为21.7/千人年和17.8/千人年，无统计学差异。发病年龄低于20岁的哮喘患者，其缓解率为21.0/千人年，与20岁以后发病的哮喘患者（19.4/千人年）相当。在观察期内，停止吸烟患者的缓解率增高；入选时无哮喘症状患者的缓解率增高。Cox回归模型分析，缓解率增高与戒烟有关(HR 1.65, 95% CI 1.01–2.71)，与入选时症状有关(HR 0.7, 95% CI 0.40–0.90)，而与过敏性鼻炎无关（HR 0.9, 95% CI 0.69-1.19）。
这一纵向研究提示，戒烟和病情较轻患者的哮喘缓解率更高，进一步强调戒烟对哮喘患者的重要性。
（韩伟 青岛大学附属青岛市立医院呼吸科 266071 摘译）
( Eur Respir J 2007; 30: 62–65)
Remission of asthma: a prospective longitudinal study from northern Europe (RHINE study)
M. Holm*, E. Omenaas#, T. Gı´slason", C. Svanes#, R. Jo¨gi+, E. Norrman1,
C. Jansone and K. Tore´n*,** on behalf of the RHINE study group
ABSTRACT: The aim of the present study was to investigate the remission rate of adult asthma in a general population sample in relation to age, sex, asthma symptoms, allergic rhinitis and smoking.
A follow-up of the random population samples from the European Community Respiratory Health Survey in Northern Europe was conducted from 1999–2001 on 1,153 individuals (aged 26– 53 yrs) with reported asthma. Remission was defined as no asthmatic symptoms in two consecutive years and no current use of asthma medication. Remission rates per 1,000 personyrs were calculated and Cox regression models, adjusting for confounders, were used to estimate hazard ratios (HR) with 95% confidence intervals (CI). An average remission rate of 20.2 per 1,000 person-yrs was found. There was no significant difference according to sex; the remission rates were 21.7 and 17.8 per 1,000 person-yrs in females and males, respectively. An increased remission rate was observed among subjects who quit smoking during the observation period. Subjects not reporting any asthma symptom at baseline had an increased remission rate. In the Cox regression model, ex-smoking (HR 1.65, 95% CI 1.01–2.71) was associated with increased remission rate, and reporting any asthma symptom at baseline was associated with decreased remission rate (HR 0.7, 95% CI 0.40–0.90).
In conclusion, the present prospective longitudinal study showed that quitting smoking and the presence of mild disease appeared to favour remission.
Holm M, Omenaas E, Gı´slason T, et al. Eur Respir J 2007; 30: 62–65
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工作环境污染与新发哮喘：国际前瞻性人群研究（ECRHS-II）
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哮喘及其严重度的评分揭示了新的基因关联位点
