| Objective:To investigate the control levels,disease management and influencing factors of patients with bronchial asthma in Nanjing city clinics in the first affiliated hospital of Nanjing Medical University,and to assist clinical management of asthma.Methods:According to the epidemiology questionnaire of asthma in China and making appropriate additions and modifications,the general information of patients was collected,the control levels of asthma and the long-term management and self-management of asthma were evaluated.According to the preset criteria,150 outpatients with asthma were included,among them 44 cases were over 60 years old.Results:1.The complete control level(27.3%)of the asthmatic patients was higher than that in the AP-AIM survey(2.0%in mainland China),and the partial control and uncontrolled levels were lower than results of the AP-AIM survey(mainland China(51.3%vs 40.0%),but compared with the results in 2008 in China the complete control rate was closer(27.3%vs 28.5%).Hospitalization,emergency treatment,missed work and misunderstanding over the past year due to acute exacerbation of asthma were lower than the national average results in 2008((12.0%vs 20.0%,27.3%vs 33.9%,22.2%vs 28.6%,9.1%vs 13.4%).2.From classification treatment,light,moderate and severe asthma in patients with the use of inhalation of the proportion were 72.4%,55.6%and 60.0%,there is still a gap with the requirements of the guidelines.3.The survey of asthma patients in the specialist program was significantly higher than the national average of the survey in 2008(41.3%vs 20.0%).And the proportion of own a peak flow meter,adhere to the daily use of peak flow meter,lung function measured in past year were lower(7.4%vs 21.8%,42.0%vs 75.4%,0.7%vs 6.6%).4.The severity of asthma affects the control levels of asthma(P<0.05).Whether using glucocorticoid inhaler or an inhaled formulation containing glucocorticosteroids of the daily using drugs is an independent risk factor for ACT scores in patients with asthma.(P<0.05).In the past year,the ACT score for patients with acute exacerbation of asthma was(18.4 ± 4.7)points and in the absence of emergency treatment was(20.9 ± 3.5)points.There was a significant difference in ACT scores between the two groups(P<0.05).In the past year,the ACT score for patients with a history of acute exacerbation of asthma was(18.8 ± 3.8)points,compared with(20.6 ± 4.0)points for patients with no history of illness.There was a significant statistical difference between ACT scores(P<0.05).5.Elderly patients with asthma with high proportion of hypertension,coronary heart disease,sleep apnea hypopnea syndrome than non-elderly patients(P<0.05).6.Unused glucocorticoid inhalation or composite containing glucocorticoid inhalation preparations was one of independent risk factors influence ACT scores in older patients(P<0.05).The past year of emergency treatment in patients with non-elderly asthma has been one of the independent risk factors for ACT scores(P<0.05).Conclusion:In recent years,the complete control level of asthma in Nanjing City,which in the first affiliated hospital of Nanjing Medical University in recent years,is similar to the national average.But the complete control rate is still not ideal,These need to strengthen the self-management of asthma and the acceptance of standardized treatment The severity of asthma has a direct impact on the level of asthma control,elderly patients with high complications,The use of a combination of glucocorticoid inhalant or glucocorticoid is important for asthma patients,especially elderly patients... |
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