一些报告记录了死于哮喘的儿童的特征;然而，据我们所知，没有研究使用病例对照来阐明与死亡相关的临床特征。我们对1973年至1982年间住院的21例严重哮喘患者进行了病例对照研究，这些患者出院后死于哮喘。平均死亡年龄为13岁(范围为8至18岁)。21例哮喘对照病例在住院时的年龄、性别和疾病的严重程度相匹配。评估医院记录的57个生理和心理变量。逐步判别分析发现，以下8个变量可有效区分两组:(1)与哮喘发作相关的癫痫发作史;(二)患者父母与医院工作人员在对患者的医疗管理方面发生冲突;(3)哮喘患者住院期间的自我护理年龄不适宜;(4)住院期间泼尼松用量减少50%以上; (5) inhaled beclomethasone dipropionate required for treatment; (6) increased asthmatic symptoms during the week preceding discharge; (7) depressive symptoms; and (8) disregard of asthmatic symptoms. Most of the clinical characteristics previously thought to place patients at greater risk for a fatal asthmatic attack were found as often in the control cases as in the children who died. This study indicates that psychologic risk factors were prominent in severely asthmatic children who subsequently died of asthma. The variables defined in this study may be important in identifying patients who are at high risk for dying of asthma and in developing treatment plans to prevent deaths.
（贾马1985; 254：1193-1198）