背景:哮喘是一种常见的慢性疾病,其特征是呼吸道症状和气流受限,影响大约4%-10%的成年人口。与没有哮喘的个体相比,成人哮喘与更高的全因死亡率相关。在这项研究中,我们调查了可能影响哮喘治疗的合并症.
方法:共有1648名成人哮喘患者和3310名30-93岁无哮喘患者与年龄相匹配,性别和居住地区,从1997年1月1日至2013年12月31日。基线信息是通过1997年问卷和芬兰卫生和福利研究所国家出院登记处的后续登记数据收集的。数据包括门诊护理和专业医疗保健日间手术的诊断,以及专业和初级卫生保健的住院护理数据。我们纳入了所有至少有200次事件的主要诊断,以及基于成人哮喘常见症状的诊断数量。
结果:平均随访时间在14.2至15.1年之间变化,非哮喘受试者的年龄为53.9岁,哮喘患者的年龄为54.4岁.慢性阻塞性肺疾病在哮喘患者中更常见10倍。急性鼻窦炎的风险,慢性鼻-鼻窦炎伴鼻息肉,特应性皮炎和声带功能障碍是肺炎的四倍,慢性鼻-鼻窦炎是哮喘患者的2.5倍。睡眠呼吸暂停,胃食管反流病,糖尿病,在哮喘组中,过敏性鼻炎和呼吸功能障碍的发生率高两倍,白内障的发生率高两倍。成人哮喘也与肌肉骨骼疾病显著相关,尿失禁和支气管扩张.
结论:本研究中成人哮喘最常见和最严重的合并症是慢性阻塞性肺疾病。成人哮喘的其他常见合并症包括急性鼻窦炎,慢性鼻-鼻窦炎伴鼻息肉,特应性皮炎,过敏性鼻炎,呼吸功能失调,糖尿病,肺炎,睡眠呼吸暂停和胃食管反流病。
BACKGROUND: Asthma is a common chronic disease characterised by variable respiratory symptoms and airflow limitation, affecting roughly 4%-10% of the adult population. Adult asthma is associated with higher all-cause mortality compared to individuals without asthma. In this study, we investigate the comorbidities that may affect the management of asthma.
METHODS: Total of 1648 adults with asthma and 3310 individuals without asthma aged 30-93 were matched with age, gender and area of residency, and followed from 1 January 1997 to 31 December 2013. Baseline information was collected with questionnaires 1997 and follow-up register data from the national discharge registry Finnish Institute for Health and Welfare. Data included diagnoses from outpatient care and day surgery of specialised health care, and data from inpatient care of specialised and primary health care. We included all main diagnoses that had at minimum 200 events and number of diagnoses based on their common appearance with adult asthma.
RESULTS: The mean follow-up time varied between 14.2 and 15.1 years, and age at the time of enrolment was 53.9 years for subjects without asthma and 54.4 years for patients with asthma. Chronic obstructive pulmonary disease was 10 times more common among asthmatics. Risk of acute rhinosinusitis, chronic rhinosinusitis with nasal polyps, atopic dermatitis and vocal cord dysfunction was fourfold and risk of pneumonia, and chronic rhinosinusitis was 2.5 times more common among asthmatics. Sleep apnoea, gastro-oesophageal reflux disease, diabetes, allergic rhinitis and dysfunctional breathing were twofold and cataract nearly twofold higher in the asthmatic group. Adult asthma was also significantly associated with musculoskeletal diseases, incontinence and bronchiectasis.
CONCLUSIONS: The most common and most severe comorbidity of adult asthma in this study was chronic obstructive pulmonary disease. Other common comorbidities of adult asthma include acute rhinosinusitis, chronic rhinosinusitis with nasal polyps, atopic dermatitis, allergic rhinitis, dysfunctional breathing, diabetes, pneumonia, sleep apnoea and gastro-oesophageal reflux disease.