哮喘联盟

   摘要
   背景：哮喘恶化与生活质量下降和卫生保健使用增加有关。对能预测次优控制哮喘患者未来哮喘恶化增加的风险的特点进行鉴定可能有助于指导治疗。
   目的：检测与控制不良的持续性哮喘恶化相关的患者特点。
   方法：对2项随机研究中进行哮喘控制治疗但仍控制不良的成人和儿童哮喘患者进行回顾性分析。将治疗过程中哮喘恶化受试者的基线特点与未恶化受试者进行比较。
   结果：718例（402例成人和295例儿童）受试者中，108例(27%)成人和110例(37%)儿童在研究期间发生哮喘恶化。前一年计划外哮喘健康随访或口服糖皮质激素的使用与研究期间的哮喘恶化显著相关(P <0 .01)。经历哮喘恶化的成年受试者与未经历者相比，第1秒用力呼气容积显著降低(2.3 vs 2.5L，P=0.02)。经历哮喘恶化的儿童使用支气管扩张剂前后的第1秒用力呼气容积的基线水平较低(77% vs 81%, P < .01; 82% vs 86%, P <0.001)。成人哮喘恶化者的症状评分验证问卷的分数明显降低，而儿童没有。
   结论：肺功能的测定有助于对哮喘恶化风险增高的成人和儿童进行鉴定。症状评分有助于对存在哮喘恶化高风险的成人进行鉴定，对儿童没有帮助。
 

（杨冬 审校）
AnnAllergyAsthmaImmunol. 2015Dec19.pii:S1081-1206(15)00798-X.doi:10.1016/j.anai.2015.11.011. [Epub ahead of print]

 

Predictors of asthma exacerbation among patients with poorly controlled asthma despite inhaled corticosteroid treatment.
 

Quezada W1, Kwak ES1, Reibman J2, Rogers L3, Mastronarde J4, Teague WG5, Wei C6, Holbrook JT6, DiMango E7.
 

Abstract
BACKGROUND:Asthma exacerbations are associated with decreased quality of life and increased health care usage. Identification of characteristics that predict increased risk of future exacerbations in patients with suboptimal control of asthma could guide treatment decisions.
OBJECTIVE:To examine patient characteristics associated with risk of asthma exacerbations in patients with uncontrolled persistent asthma.
METHODS:A retrospective analysis of adults and children with inadequately controlled asthma despite asthma controller therapy and enrolled in 2 randomized trials was conducted. Baseline characteristics of subjects who experienced an asthma exacerbation during the treatment period were compared with those of subjects who did not experience an exacerbation.
RESULTS:Of 718 subjects (402 adults and 295 children), 108 adults (27%) and 110 children (37%) experienced an asthma exacerbation during the study period. Unscheduled health care visits for asthma or use of oral corticosteroids in the previous year were significantly associated with asthma exacerbation during the study period (P < .01). Adult subjects who experienced an exacerbation had significantly lower forced expiratory volume in 1 second compared with those who did not (2.3 vs 2.5 L, respectively, P = .02). Children who experienced an exacerbation had lower baseline pre- and post-bronchodilator ratios of forced expiratory volume in 1 second to forced vital capacity (77% vs 81%, P < .01; 82% vs 86%, P < .001, respectively). Symptom scores on validated questionnaires were significantly worse in adults but not in children who developed an exacerbation.
CONCLUSION:Spirometric measurements can help identify adults and children at increased risk for asthma exacerbation. Symptom scores could be helpful in identifying adults who are at high risk for exacerbations but could be less helpful in children.
 

AnnAllergyAsthmaImmunol. 2015Dec19.pii:S1081-1206(15)00798-X.doi:10.1016/j.anai.2015.11.011. [Epub ahead of print]