对重症哮喘进行治疗管理可迅速降低哮喘住院率
2010/08/20
关键词： 哮喘；住院率；预防；治疗
哮喘是巴西住院临床病因的第三位。以免费管理重症哮喘患者为中心的哮喘控制计划(ProAR计划)在巴西Salvador市启动。为了评价这一计划对哮喘住院率的影响，Souza-Machado等分析了1998年～2006年该市哮喘住院率的变化，以及肺炎和心肌梗塞的发病率。为了外部控制，同时采集尚未启动ProAR计划的Recife市资料，该市是与Salvador最有可比性的巴西城市。
结果显示，从1998年～2006年，Salvador市的哮喘住院率下降82.3%，其中最大降幅发生在2003年，当年ProAR计划完成。而Recife市哮喘住院率的下降幅度较小。2006年Salvador市哮喘的住院率为2.25/10,000 居民，而Recife 市为17.06 /10,000 居民。在Salvador，哮喘药物提供量和哮喘住院率间存在明显的负相关(-0.801; p<0.0001)。
研究证实，Salvador 市的哮喘住院率迅速下降与针对重症哮喘的公共卫生干预计划——ProAR计划有关。因此，充分的公共卫生干预对于降低住院率、改善患者生活质量具有积极的意义。
（韩伟 青岛大学附属青岛市立医院东院 266071 摘译）
（Eur Respir J 2010; 35:515-521）
Rapid reduction in hospitalisations after an intervention to manage severe asthma
C. Souza-Machado1,2, A. Souza-Machado2,3, R. Franco2,4, E. V. Ponte2, M. L. Barreto5, L. C. Rodrigues6, J. Bousquet7,8 and A. A. Cruz2
Keywords: Asthma, hospitalisation, prevention, treatment
Asthma is the third cause of hospitalisations due to clinical illnesses in Brazil. The Programme for Control of Asthma in Bahia (ProAR) leads an initiative in Salvador City (Brazil) to manage severe asthma for free. The aim of this study was to identify trends in asthma hospitalisation in the entire city and to evaluate the impact of ProAR.
Information on asthma hospitalisations from 1998 to 2006 was collected. We analysed trends in Salvador (2.8 million inhabitants) before and after ProAR, taking pneumonia and myocardial infarction into account for local comparison. As an external control we obtained information on asthma from Recife, which is the most comparable Brazilian city.
In Salvador, asthma hospital admissions declined by 82.3% (1998–2006). A greater proportion of this reduction (74%) occurred after 2003, in parallel with the implementation of ProAR. The reduction in asthma admissions in Recife was smaller. The rates of hospitalisation in 2006 were 2.25 per 10,000 inhabitants in Salvador and 17.06 in Recife. In Salvador, we found an inverse correlation between the provision of medication for asthma and hospitalisation (-0.801; p<0.0001).
A rapid reduction in asthma admissions in the entire city of Salvador was associated with ProAR, a public health intervention targeting severe asthma.
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学校空气质量与儿童干咳、鼻炎和鼻塞有关
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父母职业是儿童喘息和哮喘的危险因素
