低分子量药物比高分子量药物会导致更严重的哮喘吗？
2016/08/31
摘要
简介：本研究的目的是分析是否由低分子量药物引起的职业性哮喘患者（OA）与由高分子量药物引起的职业性哮喘患者（OA）在危险因子、哮喘表现和程度、以及对不同诊断测试的反应存在不同。
方法：本研究总共有包含78例职业性哮喘的患者，特定的吸入物激发阳性（SIC）确诊哮喘 。对人体测量特征，过敏状态、职业、潜伏期、根据全球哮喘防治创议（GINA）控制分类的哮喘严重程度、肺功能测试和SIC结果进行了分析。
结果：高分子量药物诱导职业性哮喘23例（29%）、低分子量药物诱导职业性哮喘55例（71%）。Logistic回归分析证实，由低分子量药物诱发的职业性哮喘患者有显著较高的风险患严重哮喘（OR 3.579，95% CI 1.136-11.280；P = 0.029），严重程度是潜在的混杂因素校正后根据GINA进行的分类。在特定的吸入性激发期间（SIC），大多数由高分子药物引起的职业性哮喘患者表现为早期反应（82%），而低分子量药物引起的职业性哮喘患者主要表现为后期反应（73%）（P = 0.0001）。同样，通过测量特定的吸入激发（SIC）之前和之后乙酰甲胆碱剂量率（DRR）的不同发现：由低分子量药物引起的职业性哮喘患者（1.77，范围0-16），与高分子量药物引起的职业性哮喘患者相比（0.87，范围0-72），会出现更大程度的气道高反应性（P = 0.024）。
结论：由低分子量药物引起的职业性哮喘可能比高分子量药物引起的哮喘更严重。严重的程度可能由这些药物不同的作用机理导致。
（杨冬 审校）
PLoS One. 2016 Jun 9;11(6):e0156141. doi: 10.1371/journal.pone.0156141. eCollection 2016.
Do Low Molecular Weight Agents Cause More Severe Asthma than High Molecular Weight Agents?
Meca O1, Cruz MJ2,3, Sánchez-Ortiz M2,3, González-Barcala FJ4, Ojanguren I2,3, Munoz X2,3,5.
Author information
Abstract
INTRODUCTION:The aim of this study was to analyse whether patients with occupational asthma (OA) caused by low molecular weight (LMW) agents differed from patients with OA caused by high molecular weight (HMW) with regard to risk factors, asthma presentation and severity, and response to various diagnostic tests.
METHODS:Seventy-eight patients with OA diagnosed by positive specific inhalation challenge (SIC) were included. Anthropometric characteristics, atopic status, occupation, latency periods, asthma severity according to the Global Initiative for Asthma (GINA) control classification, lung function tests and SIC results were analysed.
RESULTS:OA was induced by an HMW agent in 23 patients (29%) and by an LMW agent in 55 (71%). A logistic regression analysis confirmed that patients with OA caused by LMW agents had a significantly higher risk of severity according to the GINA classification after adjusting for potential confounders (OR = 3.579, 95% CI 1.136-11.280; p = 0.029). During the SIC, most patients with OA caused by HMW agents presented an early reaction (82%), while in patients with OA caused by LMW agents the response was mainly late (73%) (p = 0.0001). Similarly, patients with OA caused by LMW agents experienced a greater degree of bronchial hyperresponsiveness, measured as the difference in the methacholine dose-response ratio (DRR) before and after SIC (1.77, range 0-16), compared with patients with OA caused by HMW agents (0.87, range 0-72), (p = 0.024).
CONCLUSIONS:OA caused by LMW agents may be more severe than that caused by HMW agents. The severity of the condition may be determined by the different mechanisms of action of these agents.
PLoS One. 2016 Jun 9;11(6):e0156141. doi: 10.1371/journal.pone.0156141. eCollection 2016.
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