[Comparative analysis of the state of asthma prevalence in children from two nation-wide surveys in 1990 and 2000 year].
[Comparative analysis of the state of asthma prevalence in children from two nation-wide surveys in 1990 and 2000 year].
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发表时间：
2004-02
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通讯作者：
Yu-zhi Chen
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作者：
Yu-zhi Chen
目的了解10年间0 ~ 14岁儿童哮喘患病率的变化。方法在全国范围内随机抽取27个市（自治区），按中南、西南、华东、东北、西北、华北6个地区进行比较。调查仅在城市地区进行，包括2000年287 329名0 - 14岁儿童和1990年399 193名儿童。2000年共筛查出哮喘相关儿童4301例（1.50%）。其中3540 3岁及以上儿童哮喘发病率为82.31%; 3岁以下婴幼儿哮喘占17.69%; 1990年，诊断为哮喘者2691例，占0.91%; 3岁及以上儿童占74.23%，年龄<3岁者占25.77%;男性患病率高于女性，男女患病率分别为1.85%（2 733/147 969）和1.13%（1568/139，360），2000年患病率为1.74：1.00，男女患病率均为1.08%（2265/210，137）和0.72%（1360/189，056），比率为1.67：1.00]。约90%的哮喘儿童在6岁以前开始喘息[2000年为90.30%（3884/4301），1990年为95.26%（3453/3625）]。1990年和2000年0 ~ 14岁哮喘人群（包括大龄儿童和婴幼儿哮喘）的平均患病率分别为0.91%和1.50%。目前患病率上升了64.84%。2000年上海（483/14,468）和重庆（374/11,200）哮喘患病率最高，均为3.34%，拉萨（35/6676）最低，为0.52%。1990年重庆市最高（199/7651），为2.60%，拉萨市最低（14/15,360），为0.09%。两次调查显示，2000年95%以上的患者使用抗生素治疗，35.41%（1523/4301）的患者使用吸入性糖皮质激素治疗，1990年已很少使用。结论10年间哮喘患病率呈明显上升趋势（64.84%）。从目前的调查资料可以推断，各城市儿科医生对哮喘的诊断准确率和激素吸入治疗的实施情况有了很大的改善，但仍需大力推广GINA，提高哮喘儿童的生活质量。
OBJECTIVE To find out the prevalence change of asthma in children aged 0 - 14 years during the ten years. METHODS A nationwide randomized survey, covering 27 cities, 27 identical cities/municipalities were chosen for comparison which were divided into 6 sections: mid-south, southwest districts, east-China section, northeast, northwest and north-China districts. RESULTS Surveys were exclusively in the urban areas, including a population of 287,329 children aged 0 - 14 years in 2000 and 399,193 children in 1990. 4301(1.50%) were screened out as asthma associated children in 2000. Among them 3540(82.31%) children, aged 3 years or more, were diagnosed as asthma of children; 761 (17.69%) as asthma of infants and young children aged less than 3 years; In 1990, 3625 (0.91%) were diagnosed as asthma, and in which 2691 (74.23%) were children aged 3 years or more, other 934 (25.77%) were aged less than 3 years; And male predominate female [the prevalence of male and female are 1.85% (2 733/147 969) and 1.13% (1568/139,360), the rate is 1.74:1.00 in 2000, the prevalence of male and female are 1.08% (2265/210,137) and 0.72% (1360/189,056), the rate is 1.67:1.00 in 1990]. About 90% asthmatic children had onset of wheezing before 6 years old [90.30% (3884/4301) in 2000, and 95.26% (3453/3625) in 1990]. The prevalence of the average asthma of all the 0 - 14 years old asthma population (including asthma of older children and of infants) in 1990 and 2000 is 0.91% and 1.50% respectively. The current prevalence has increased by 64.84%. There was statistically significant difference in asthma prevalence among the 27 cities, in 2000 bring the highest in Shanghai (483/14,468) and Chongqing (374/11,200), both are 3.34%, and the lowest in Lhasa (35/6676), is 0.52%. In 1990, the highest in Chongqing (199/7651) is 2.60%, the lowest in Lhasa (14/15,360) is 0.09%. Two surveys showed that more than 95% patients were treated with antibiotics, and about 35.41% (1523/4301) with the inhaled glucocorticosteroid in 2000, in 1990 it is very rarely. CONCLUSIONS There has been a significant increasing trend (64.84%) of asthma prevalence during the ten years. >From the data of present survey it was inferred that there has been quite some improvement in the accuracy of diagnosis and in the practice of steroid inhalation therapy by the pediatricians in different cities, but we must generalize the GINA hardly and improve the quality of asthmatic children's lives.