Asthma Severity According to Global Initiative for Asthma and Its Determinants: An International Study
Asthma Severity According to Global Initiative for Asthma and Its Determinants: An International Study
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DOI：
10.1159/000232572
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发表时间：
2010-01-01
影响因子：
2.8
通讯作者：
de Marco, Roberto
中科院分区：
文献类型：
--
作者：
Cazzoletti, Lucia;Marcon, Alessandro;de Marco, Roberto
背景资料：识别与严重哮喘相关的因素可能有助于了解其病因及其发展机制。我们的目的是使用全球哮喘倡议（GINA）分类来描述哮喘的严重程度，并在欧洲的一个横断面的、基于人群的样本中调查其决定因素。方法：在欧洲共同体呼吸健康调查II（1999-2002）中，确定了1,241名成人哮喘患者。使用2002年GINA分类（间歇性、轻度持续性、中度持续性、重度持续性）评估严重程度，并使用间歇性组作为相对风险比的参考类别，通过多项logistic模型将其与潜在决定因素相关。结果：约30%的哮喘患者患有中重度哮喘。与间歇性哮喘相比，对枝孢霉属的致敏与持续性哮喘（轻度、中度或重度）的风险高5倍以上相关。持续性哮喘与屋尘螨致敏、非季节性哮喘、哮喘发作年龄较大、慢性咳嗽和痰呈正相关。对猫过敏只增加严重哮喘的风险。吸烟与男性哮喘严重程度的相关性更强，而鼻炎与女性哮喘严重程度的相关性更强。结论：三分之一的哮喘人群患有中度至重度哮喘。对室内常年性过敏原，特别是枝孢菌属过敏，与哮喘严重程度密切相关。吸烟和鼻炎在确定哮喘严重程度方面的作用可能在性别之间存在差异，这需要进一步研究。版权所有（C）2009 S. Karger AG，巴塞尔
Background: The identification of the factors associated with severe asthma may shed some light on its etiology and on the mechanisms of its development. We aimed to describe asthma severity using the Global Initiative for Asthma (GINA) classification and to investigate its determinants in a cross-sectional, population-based sample in Europe. Methods: In the European Community Respiratory Health Survey II (1999-2002), 1,241 adults with asthma were identified. Severity was assessed using the 2002 GINA classification (intermittent, mild persistent, moderate persistent, severe persistent) and it was related to potential determinants by a multinomial logistic model, using the intermittent group as the reference category for relative risk ratios. Results: About 30% of asthmatic subjects were affected by moderate-to-severe asthma. Sensitization to Cladosporium was associated with a more than 5-fold greater risk of having (mild, moderate or severe) persistent asthma than intermittent asthma. Persistent asthma was positively associated with sensitization to house dust mite, nonseasonal asthma, an older age at asthma onset, and chronic cough and phlegm. Sensitization to cat increased the risk of severe asthma only. Smoking was more strongly associated with asthma severity in men, while rhinitis was more strongly associated with asthma severity in women. Conclusions: One third of the asthmatic population have moderate-to-severe asthma. Sensitization to perennial indoor allergens, particularly Cladosporium, is strongly associated with asthma severity. The role of smoking and rhinitis in determining asthma severity may differ between the sexes, and it should be further investigated. Copyright (C) 2009 S. Karger AG, Basel