急性細支氣管炎和兒童哮喘之間的關係：台灣健保資料庫1996年至2003年之分析研究

Establishing the relationship between acute bronchiolitis and childhood asthma using Taiwanese health insurance claims from 1996 to 2003

目的：哮喘從21世紀初以來日益受到關注。了解這種疾病的發病因素，可能會降低兒童哮喘的患病率。從台灣全民健康保險局的記錄，本文研究了急性細支氣管炎和兒童哮喘之間的關係。其研究結果於未來可能有助於理解和控制這兩種疾病。方法：本次研究主要在曾經3歲以前發生過急性細支氣管炎的病患，跟兒童哮喘病患之間的關係作討論。由於數據庫的限制，所以此研究只能世代追查研究至七年。結果：本研究指出3歲以前曾診斷為急性細支氣管炎大約有5000個病患。使用科克倫趨勢阿米蒂奇測試檢測，此線性傾向的關係。發現從健保資料庫的數據指出3歲以前曾經發生過急性細支氣管炎的病患，那麼他們未來發生兒童哮喘的發病率較高。結論： （1） 急性細支氣管炎可能跟未來發展哮喘上有關係；（2） 減少急性細支氣管炎的發病率，未來可能有助於減少哮喘的發生。這將降低醫療保險支出。

Objective: Asthma has become a growing concern since the beginning of the twenty-first century. Understanding the pathogenesis of risk factors for this disease may reduce the prevalence of childhood asthma. This study uses records from the Taiwanese National Health Insurance Bureau to explore the relationship between acute bronchiolitis and childhood asthma. Its findings may contribute to a better understanding and control of these 2 diseases. Methods: This study identifies patients with acute bronchiolitis episodes before age 3. Database limitations only permitted a cohort of 7 years for these patients. This study also examines the relationship between childhood asthma and acute bronchiolitis in this cohort. Results: This study identifies 5000 patients diagnosed with acute bronchiolitis be ore age 3. The Cochran-Armitage trend test detects the linear trends in this relationship. The National Health Insurance Database sample in this study shows a higher prevalence of asthma from age 4 to 7 among those who had acute bronchiolitis before age 3. Conclusion: (1) Acute bronchiolitis is related to subsequent development of asthma; and (2) Reducing the prevalence of acute bronchiolitis reduces the occurrence of asthma. This in turn can reduce health insurance claims.