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目的:探讨吸入糖皮质激素是否能有效预防哮喘的发病率及再次住院率。方法:在S省医疗数据库内,将2001年和2003年内5～54岁的哮喘患者分为两组。第一组对哮喘患者进行所有项目的治疗,第二组对哮喘患者出院后的治疗。1年后对受试者进行随访,并持续到2011年,其中受试者的年龄在受试期间不能超过54岁,死亡患者也不包括在内。分别对第一哮喘入院和再入院进行随访。病例对照分析重度哮喘患者和正常对照组的历时和标记。结果:在305例哮喘患者中,有78名患者接受医院治疗,有38名患者接受再次入院治疗。即每年1 000名住院的哮喘患者中就有42.4名接受再次住院治疗。常规吸入糖皮质激素可使哮喘患者入院率减少31%(95%置信区间17-43)再入院率减少39%(95%CI25-50)。在4年的随访中发现,哮喘患者的入院率和再入院率可在很长的时期内保持很低的水平。常规吸入糖皮质激素可使每年每1 000名哮喘患者中有5名患者免于入院治疗,27名患者免于再次入院治疗。结论:在哮喘早期和晚期,常规吸入低剂量糖皮质激素可预防相当大比例哮喘患者的发作。
Objective: To investigate whether inhaled corticosteroids can effectively prevent the incidence of asthma and re-hospitalization rate. Methods: The asthma patients aged 5 to 54 years in 2001 and 2003 were divided into two groups in the provincial medical database. The first group treated all patients with asthma and the second group treated patients discharged from asthma. Subjects were followed up 1 year later and continued until 2011, where subjects were 54 years or younger during the study period and were not included in the deaths. The first asthma admission and re-admission were followed up. Case-control analysis of latencies and markers in patients with severe asthma and normal controls. RESULTS: Of the 305 asthmatic patients, 78 were hospitalized and 38 were admitted to hospital again. That is, 42.4 out of 1,000 hospitalized asthmatics per year receive rehospitalization. Routine inhaled corticosteroids reduced asthma admission rates by 31% (95% confidence interval 17-43) and 39% (95% CI 25-50) in readmissions. At 4 years of follow-up, it was found that admission and readmission rates for asthma patients remained low for very long periods of time. Conventional inhaled corticosteroids prevented 5 out of 1,000 patients per year from hospital admission and 27 from hospitalization. Conclusions: Routine inhalation of low-dose glucocorticoids prevented the onset of a substantial proportion of asthmatics in early and late asthma.