哮喘的频繁或罕见发作的比较特征：回顾性和前瞻性事件的纵向研究
2017/10/23
摘要
背景和目的：“频繁发作表型”已被描述，主要存在于重症哮喘患者人群中。有发作倾向的轻度哮喘需要进一步的数据资料。比较不同严重程度的频繁发作和非频繁发作哮喘患者的特征，评估发作患者的状态稳定性。
方法：这是一项对比频繁发作（≥2次/年）和非频繁发作（＜2次/年）基础资料的观察性研究。患者被随访一年。在基线和为期一年的随访中收集有关临床、生理和炎症特征的信息。
结果:共有47名频繁发作患者和53名非频繁发作患者入组。频繁发作组和非频繁发作组在基线上无临床、生理和炎症特征的差异性。随访一年后58%哮喘患者出现频繁发作。轻中度哮喘和重症哮喘患者分别有42%和62%出现频繁发作。根据哮喘严重程度进行分析，重症哮喘频繁发作患者较轻中度哮喘频繁发作患者有更高的体重指数和哮喘控制较差，虽然重症哮喘频繁发作患者有更好的依从性。相同严重程度的哮喘患者频繁发作组和非频繁发作组之间无显著差异性。
结论：重症哮喘频繁发作患者较轻中度哮喘频繁发作患者有显著差异。但是，轻中度哮喘频繁发作患者需要重新评估治疗需求和潜在的作用因素。
Comparative features of Asthma with frequent or infrequent exacerbations: A longitudinal study of retrospective and prospective events.
Boulay MÈ1, Pruneau-Pomerleau C1, Villeneuve H1, Deschesnes F1, Ringuette L1, Boulet LP1.
Abstract
BACKGROUND AND AIM:A "frequent exacerbator phenotype" has been described, mostly in the population of patients with severe asthma. Further data are needed on such exacerbation-prone patients in milder asthma. To compare the characteristics of frequent and nonfrequent exacerbators in asthma of different severities and to assess the stability of the exacerbator status.
METHODS:This was an observational study comparing baseline data from frequent (≥2 exacerbations in the past year) and nonfrequent (<2 exacerbations in the past year) exacerbators. Patients were also followed up for one year. Information regarding clinical, physiologic, and inflammatory characteristics was collected at baseline and one-year follow-up.
RESULTS:Forty-seven frequent and 53 nonfrequent exacerbators were recruited. No specific clinical, physiologic, or inflammatory characteristic was observed in the frequent as compared to the nonfrequent exacerbators at baseline. Fifty-eight percent of patients reporting frequent exacerbations at baseline remained in this group after one year of follow-up. Forty-two and 62% of patients with, respectively, mild-to-moderate asthma and severe asthma had frequent exacerbations. In a post hoc analysis according to asthma severity, frequent exacerbators with severe asthma had a higher body mass index and poorer asthma control, although they reported higher adherence to medication, in comparison to frequent exacerbators with mild-to-moderate asthma. No specific characteristics could discriminate between frequent and nonfrequent exacerbators of the same asthma severity.
CONCLUSIONS:Frequent exacerbators with severe asthma present some specific characteristics not observed in frequent exacerbators with mild-to-moderate disease. However, the latter group should be identified to reassess treatment needs and potential contributing factors.
背景和目的：“频繁发作表型”已被描述，主要存在于重症哮喘患者人群中。有发作倾向的轻度哮喘需要进一步的数据资料。比较不同严重程度的频繁发作和非频繁发作哮喘患者的特征，评估发作患者的状态稳定性。
方法：这是一项对比频繁发作（≥2次/年）和非频繁发作（＜2次/年）基础资料的观察性研究。患者被随访一年。在基线和为期一年的随访中收集有关临床、生理和炎症特征的信息。
结果:共有47名频繁发作患者和53名非频繁发作患者入组。频繁发作组和非频繁发作组在基线上无临床、生理和炎症特征的差异性。随访一年后58%哮喘患者出现频繁发作。轻中度哮喘和重症哮喘患者分别有42%和62%出现频繁发作。根据哮喘严重程度进行分析，重症哮喘频繁发作患者较轻中度哮喘频繁发作患者有更高的体重指数和哮喘控制较差，虽然重症哮喘频繁发作患者有更好的依从性。相同严重程度的哮喘患者频繁发作组和非频繁发作组之间无显著差异性。
结论：重症哮喘频繁发作患者较轻中度哮喘频繁发作患者有显著差异。但是，轻中度哮喘频繁发作患者需要重新评估治疗需求和潜在的作用因素。
(中日友好医院呼吸与危重症医学科 王瑞茵 摘译 林江涛 审校)
(J Asthma. 2017 Oct 11:1-13. doi: 10.1080/02770903.2017.1323918. [Epub ahead of print])
(J Asthma. 2017 Oct 11:1-13. doi: 10.1080/02770903.2017.1323918. [Epub ahead of print])
Comparative features of Asthma with frequent or infrequent exacerbations: A longitudinal study of retrospective and prospective events.
Boulay MÈ1, Pruneau-Pomerleau C1, Villeneuve H1, Deschesnes F1, Ringuette L1, Boulet LP1.
Abstract
BACKGROUND AND AIM:A "frequent exacerbator phenotype" has been described, mostly in the population of patients with severe asthma. Further data are needed on such exacerbation-prone patients in milder asthma. To compare the characteristics of frequent and nonfrequent exacerbators in asthma of different severities and to assess the stability of the exacerbator status.
METHODS:This was an observational study comparing baseline data from frequent (≥2 exacerbations in the past year) and nonfrequent (<2 exacerbations in the past year) exacerbators. Patients were also followed up for one year. Information regarding clinical, physiologic, and inflammatory characteristics was collected at baseline and one-year follow-up.
RESULTS:Forty-seven frequent and 53 nonfrequent exacerbators were recruited. No specific clinical, physiologic, or inflammatory characteristic was observed in the frequent as compared to the nonfrequent exacerbators at baseline. Fifty-eight percent of patients reporting frequent exacerbations at baseline remained in this group after one year of follow-up. Forty-two and 62% of patients with, respectively, mild-to-moderate asthma and severe asthma had frequent exacerbations. In a post hoc analysis according to asthma severity, frequent exacerbators with severe asthma had a higher body mass index and poorer asthma control, although they reported higher adherence to medication, in comparison to frequent exacerbators with mild-to-moderate asthma. No specific characteristics could discriminate between frequent and nonfrequent exacerbators of the same asthma severity.
CONCLUSIONS:Frequent exacerbators with severe asthma present some specific characteristics not observed in frequent exacerbators with mild-to-moderate disease. However, the latter group should be identified to reassess treatment needs and potential contributing factors.
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英国婴幼儿到老年哮喘的发作风险和特征
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哮喘与患冠心病的风险：相关队列研究的META分析
