根据国际儿童哮喘及过敏研究 (ISAAC),11.5% 的 6-7 岁儿童和 14.1% 的 13-14 岁儿童报告其目前存在哮喘症状。不同国家之间的患病率差异很大:在 13-14 岁年龄组中,北美洲有 23.3% 的女孩和 19.8% 的男孩报告其目前存在哮喘症状,而印度次大陆的相应数据分别为 5.4% 和 8.6%。一般而言,北美、拉美、大洋洲和西欧的患病率最高(>15%),而印度次大陆、亚太地区、东地中海以及北欧和东欧地区患病率最低。非洲患病率处于中等水平(10%-15%)。[1]Mallol J, Crane J, von Mutius E, et al; ISAAC Phase Three Study Group. The International Study of Asthma and Allergies in Childhood (ISAAC) phase three: a global synthesis. Allergol Immunopathol (Madr). 2013;41:73-85.http://www.elsevier.es/en-revista-allergologia-et-immunopathologia-105-articulo-the-international-study-asthma-allergies-S0301054612001097http://www.ncbi.nlm.nih.gov/pubmed/22771150?tool=bestpractice.com
在北美,估计有 620 万哮喘儿童,儿童患病率为 84/1000。[2]Centers for Disease Control and Prevention. Most recent asthma data. June 2017. https://www.cdc.gov/ (last accessed 21 July 2017).https://www.cdc.gov/asthma/most_recent_data.htm 之前报道的不断上升的患病率似乎趋于稳定,甚至可能在下降。[3]Downs SH, Marks GB, Sporik R, et al. Continued increase in the prevalence of asthma and atopy. Arch Dis Child. 2001;84:20-23.http://adc.bmj.com/content/84/1/20.longhttp://www.ncbi.nlm.nih.gov/pubmed/11124778?tool=bestpractice.com[4]Anderson HR, Gupta R, Strachan DP, et al. 50 years of asthma: UK trends from 1955 to 2004. Thorax. 2007;62:85-90.http://www.ncbi.nlm.nih.gov/pubmed/17189533?tool=bestpractice.com[5]Moorman JE, Rudd RA, Johnson CA, et al. National surveillance for asthma - United States, 1980-2004. MMWR Surveill Summ. 2007;56:1-54.http://www.cdc.gov/mmwr/preview/mmwrhtml/ss5608a1.htmhttp://www.ncbi.nlm.nih.gov/pubmed/17947969?tool=bestpractice.com 在美国,将近 50% 的哮喘患儿诉其在过去 12 个月内曾有一次或多次哮喘发作。[2]Centers for Disease Control and Prevention. Most recent asthma data. June 2017. https://www.cdc.gov/ (last accessed 21 July 2017).https://www.cdc.gov/asthma/most_recent_data.htm 在美国,从 2007 年到 2009 年,有 10.7% 的 18 岁以下哮喘儿童每年因急性发作而前往急诊科就诊,2.1% 的 18 岁以下哮喘儿童每年因哮喘而住院。[6]Moorman JE, Akinbami LJ, Bailey CM, et al; CDC National Center for Health Statistics. National surveillance of asthma: United States, 2001-2010. Vital Health Stat. 2012;3:1-58.https://www.cdc.gov/nchs/data/series/sr_03/sr03_035.pdfhttp://www.ncbi.nlm.nih.gov/pubmed/24252609?tool=bestpractice.com 目前哮喘发作是儿童住院的第三大原因。[7]American Lung Association. Asthma and children fact sheet. February 2017. http://www.lungusa.org/ (last accessed 21 July 2017).http://www.lung.org/lung-health-and-diseases/lung-disease-lookup/asthma/learn-about-asthma/asthma-children-facts-sheet.html 尽管许多高收入国家的哮喘死亡率已有所下降,但哮喘死亡率仍然是人们持续关注的问题,尤其当一些可避免的因素可能对死亡发挥作用时。[8]Global Asthma Network. The global asthma report 2014. 2014. http://www.globalasthmareport.org/ (last accessed 21 July 2017).http://www.globalasthmareport.org/resources/Global_Asthma_Report_2014.pdf
在儿童时期,男孩的哮喘患病率较高,为65%:35%(男:女)。 青春期,两性之间的哮喘患病率大致相等(50%:50%),而到成年期转为女性患病率更高(65%:35%)。[9]Toelle BG, Xuan W, Peat JK, et al. Childhood factors that predict asthma in young adulthood. Eur Respir J. 2004;23:66-70.http://erj.ersjournals.com/content/23/1/66.fullhttp://www.ncbi.nlm.nih.gov/pubmed/14738233?tool=bestpractice.com[10]Aberg N, Engstrom I. Natural history of allergic diseases in children. Acta Paediatr Scand. 1990;79:206-211.http://www.ncbi.nlm.nih.gov/pubmed/2321483?tool=bestpractice.com 确切的原因目前仍不清楚,但可能与激素相关。[11]Almqvist C, Worm M, Leynaert B; working group of GA2LEN WP 2.5 Gender. Impact of gender on asthma in childhood and adolescence: a GA2LEN review. Allergy. 2008;63:47-57.http://www.ncbi.nlm.nih.gov/pubmed/17822448?tool=bestpractice.com
哮喘患病率也因种族而异;在美国,波多黎各人的患病率最高。[6]Moorman JE, Akinbami LJ, Bailey CM, et al; CDC National Center for Health Statistics. National surveillance of asthma: United States, 2001-2010. Vital Health Stat. 2012;3:1-58.https://www.cdc.gov/nchs/data/series/sr_03/sr03_035.pdfhttp://www.ncbi.nlm.nih.gov/pubmed/24252609?tool=bestpractice.com 不同种族间患病率的差异归因于不同的医疗保健水平、社会经济状况和健康理念而非遗传因素。急性哮喘发作的发病率随季节而变化;急性加重高峰期在初秋,其中20%到25%的哮喘需要入院治疗。[12]Johnston NW, Sears MR. Asthma exacerbations. 1: epidemiology. Thorax. 2006;61:722-728.http://www.ncbi.nlm.nih.gov/pubmed/16877691?tool=bestpractice.com 这是由于上呼吸道病毒感染的季节性高峰期在相同的时间。上呼吸道感染和哮喘住院的季节性模式的显著相关性已经被证明。[13]Johnston SL, Pattemore PK, Sanderson G, et al. The relationship between upper respiratory infections and hospital admissions for asthma: a time-trend analysis. Am J Respir Crit Care Med. 1996;154:654-660.http://www.ncbi.nlm.nih.gov/pubmed/8810601?tool=bestpractice.com