控制儿童哮喘如何选择用药.ppt

* * * * Patients can also contribute to the problem, because they are well known to underestimate asthma control. A survey carried out in patients who had severe, persistent symptoms found that approximately 5–10% of patients (depending on region) felt that they had complete control, while approximately 35–50% felt that they had complete or good control. This does not give us confidence that control is being achieved where we think it should be achieved. * Asthma Phys. MDS 3/99 - 10/99 In the European study by Rabe and colleagues, it was calculated that only about 5% of patients achieved asthma control as defined by GINA guidelines. * Using the same methodology, which is comparable because the surveys used the same set of questions, and all data were analyzed in the same way, so we can compare the impact of asthma in quality of life in Japan, Asia Pacific, Europe, USA, and now ….Latin America. * Using the same methodology, which is comparable because the surveys used the same set of questions, and all data were analyzed in the same way, so we can see here figures about hospital visits and emergency room visits in Japan, Asia Pacific, Europe, USA, and now ….Latin America. * The economic burden of the disease can be also expressed in frequency of school and work absence, in Japan, Asia Pacific, Europe, USA, and now Latin America showed outstanding bad figures, the highest in the world. * * * * * * 哮喘患者会不会死？上图可以看到在1992年Robertson教授（澳大利亚）作的一项为期3年的，年龄小于20岁的哮喘患者中，对因哮喘而死亡的病例研究结果表明：在因哮喘而死亡的患者中(N=51)，哮喘各个疾病分级的所占的比例相近，也就是说，因哮喘而死亡的患者，与哮喘疾病的严重度没有直接相关性，不是说重度的哮喘患者占死亡人数比例就大，轻度患者占比例就小。我们发现轻度哮喘患者与重度哮喘患者占因哮喘而死亡的患者总数的比例是一样的。因此轻度哮喘不应该被忽视，应及早救治。 * * The fact that inhaled steroids should be administered to children with asthma is well accepted. However, there is evidence that for the child to receive optimal benefit, inhaled steroids should be introduced as soon as possible after the diagnosis of asthma has been made. This slide illustrates the improved lung function that is achiev