哮喘联盟

   摘要
   目的：哮喘和腹主动脉瘤(AAA)均与炎症反应有关。然而，这两种疾病是否相互影响尚不得而知。
   方法与结果：本研究的数据包括了丹麦全国患者注册研究，该研究是一项以人群为基础的全国性病例对照研究，纳入了1996-2002年丹麦所有的腹主动脉瘤破裂患者及与其对照的年龄、性别相匹配的腹主动脉瘤无破裂患者；丹麦维堡血管试验是以人群为基础的、随机性的维堡血管筛查试验的亚组研究。根据医院诊断、支气管扩张剂的应用和其他平喘处方药的使用记录对哮喘患者进行分类。丹麦全国患者注册研究中哮喘与腹主动脉瘤破裂风险是否有关、维堡血管试验中哮喘是否是腹主动脉瘤的独立危险因素运用Logistic回归分析模型来判定。
   结果：丹麦全国患者登记研究中，索引日前哮喘确诊时间<1年或6个月的患者，经校正腹主动脉瘤共病前后，哮喘增加腹主动脉瘤破裂风险，校正前(OR = 1.60 - 2.12)，校正后风险亦增加(OR = 1.51 - 2.06)。支气管扩张剂的应用增加了从用药至索引日90天内腹主动脉瘤破裂风险，未校正时如此(OR = 1.10 - 1.37)，校正后亦如此(OR = 1.10 - 1.31)。患者应用哮喘治疗药物也增加了腹主动脉瘤破裂风险，未校正时如此(OR = 1.12 - 1.79)，校正后亦如此(OR = 1.09 - 1.48)。维堡血管试验中，未校正抽烟或其他危险因素时，哮喘治疗药物的使用与腹主动脉瘤风险增加有关(OR = 1.45)；校正抽烟后，风险依然增加(OR = 1.45)；校正其他危险因素后亦如此(OR = 1.46)。
   结论：近期哮喘发作可增加腹主动脉瘤及其破裂风险。这一结果证实了气道疾病与腹主动脉瘤之间的联系，而这两种常见病均与炎症反应有关。

 

（杨冬 审校）
Arterioscler Thromb Vasc Biol. 2016 Feb 11. pii: ATVBAHA.115.306497. [Epub ahead of print]

 

Asthma Associates With Human Abdominal Aortic Aneurysm and Rupture.
 

Liu CL1, Wemmelund H1, Wang Y1, Liao M1, Lindholt JS1, Johnsen SP1, Vestergaard H1, Fernandes C1, Sukhova GK1, Cheng X1, Zhang JY1, Yang C1,Huang X1, Daugherty A1, Levy BD1, Libby P1, Shi GP2.
 

Abstract
OBJECTIVE:Both asthma and abdominal aortic aneurysms (AAA) involve inflammation. It remains unknown whether these diseases interact.
APPROACH AND RESULTS:Databases analyzed included Danish National Registry of Patients, a population-based nationwide case-control study included all patients with ruptured AAA and age- and sex-matched AAA controls without rupture in Denmark from 1996 to 2012; Viborg vascular trial, subgroup study of participants from the population-based randomized Viborg vascular screening trial. Patients with asthma were categorized by hospital diagnosis, bronchodilator use, and the recorded use of other anti-asthma prescription medications. Logistic regression models were fitted to determine whether asthma associated with the risk of ruptured AAA in Danish National Registry of Patients and an independent risk of having an AAA at screening in the Viborg vascular trial.
Results:From the Danish National Registry of Patients study, asthma diagnosed <1 year or 6 months before the index date increased the risk of AAA rupture before (odds ratio [OR]=1.60-2.12) and after (OR=1.51-2.06) adjusting for AAA comorbidities. Use of bronchodilators elevated the risk of AAA rupture from ever use to within 90 days from the index date, before (OR=1.10-1.37) and after (OR=1.10-1.31) adjustment. Patients prescribed anti-asthma drugs also showed an increased risk of rupture before (OR=1.12-1.79) and after (OR=1.09-1.48) the same adjustment. In Viborg vascular trial, anti-asthmatic medication use associated with increased risk of AAA before (OR=1.45) or after adjustment for smoking (OR=1.45) or other risk factors (OR=1.46).
CONCLUSIONS:Recent active asthma increased risk of AAA and ruptured AAA. These findings document and furnish novel links between airway disease and AAA, 2 common diseases that share inflammatory aspects.
 

Arterioscler Thromb Vasc Biol. 2016 Feb 11. pii: ATVBAHA.115.306497. [Epub ahead of print]