支气管热成形术治疗严重持续性哮喘的疗效和安全性
2017/12/20
摘要
背景：哮喘是一种常见疾病，仍然有一部分患者在最大治疗方面控制不佳。支气管热成形术是一种使用射频能量减少气道平滑肌的支气管镜治疗，虽然有关长期疗效和安全性的进一步证据是必需的，但已显示其改善了哮喘控制。我们旨在证明支气管热成形术的安全性和有效性。之前我们在2016年报告了该组的最初经验，其中患者在治疗后1年哮喘控制测试（ACT）评分显示有显着改善。
方法：我们对爱尔兰重症哮喘中心2012年至2013年接受支气管热成形术的7例患者进行了回顾性观察性研究。主要终点是ACT分数从基线到现在的变化。在爱尔兰的三级转诊中心，七名患者接受了支气管热成形术。收集手术前和长期随访中的哮喘控制测试分数和入院，加重，维持需求的皮质类固醇，急救支气管扩张剂的使用和FEV1的数据。平均随访49.42个月。
结果:中位数住院率（12个月以上的中位数分别为3,1 p = 0.059）和哮喘控制测试评分（9至13分）（p = 0.249）呈现改善趋势。平均FEV1治疗前为1.68L，治疗后4年为1.46L（P = 0.237）。该组没有死亡。
结论：这些数据支持支气管热成形术的安全性并提示长期有效性。
The efficacy and safety of Bronchial Thermoplasty in Severe Persistent Asthma on extended follow-up.
O'Reilly A1, Browne I1, Watchorn D1, Egan JJ2, Lane S1,3.
Abstract
BACKGROUND:Asthma is a common condition and there remains a subset of patients who are poorly controlled on maximal therapy. Bronchial thermoplasty is a bronchoscopic therapy using radio frequency energy to reduce airway smooth muscle which has been shown to improve asthma control although further evidence regarding long term efficacy and safety is required. We aimed to demonstrate safety and efficacy of bronchial thermoplasty on extended follow up. Our initial experience with this group was previously reported in 2016 where patients were shown to have a significant improvement in Asthma Control Test (ACT) scores 1 year post treatment8.
METHODS:We carried out a retrospective observational study of 7 patients who underwent bronchial thermoplasty between 2012 and 2013 in an Irish severe asthma centre. The primary endpoint was change in ACT scores from baseline to present. Seven patients underwent bronchial thermoplasty at a tertiary referral centre in Ireland. Asthma Control Test scores and data on hospital admissions, exacerbations, maintenance corticosteroid requirements, rescue bronchodilator use and FEV1 prior to the procedure and on extended follow up were collected. Mean follow up was 49.42 months.
RESULTS:A trend towards improvement was seen in median hospitalisations (respective values for median over 12 months 3, 1 p = 0.059) and Asthma Control Test scores, from 9 to 13 (p = 0.249). Mean FEV1 was 1.68L prior to treatment and 1.46L 4 years post treatment (p = 0.237). There was no mortality among the group.
CONCLUSIONS:These data support the safety of bronchial thermoplasty and suggest extended efficacy.
背景：哮喘是一种常见疾病，仍然有一部分患者在最大治疗方面控制不佳。支气管热成形术是一种使用射频能量减少气道平滑肌的支气管镜治疗，虽然有关长期疗效和安全性的进一步证据是必需的，但已显示其改善了哮喘控制。我们旨在证明支气管热成形术的安全性和有效性。之前我们在2016年报告了该组的最初经验，其中患者在治疗后1年哮喘控制测试（ACT）评分显示有显着改善。
方法：我们对爱尔兰重症哮喘中心2012年至2013年接受支气管热成形术的7例患者进行了回顾性观察性研究。主要终点是ACT分数从基线到现在的变化。在爱尔兰的三级转诊中心，七名患者接受了支气管热成形术。收集手术前和长期随访中的哮喘控制测试分数和入院，加重，维持需求的皮质类固醇，急救支气管扩张剂的使用和FEV1的数据。平均随访49.42个月。
结果:中位数住院率（12个月以上的中位数分别为3,1 p = 0.059）和哮喘控制测试评分（9至13分）（p = 0.249）呈现改善趋势。平均FEV1治疗前为1.68L，治疗后4年为1.46L（P = 0.237）。该组没有死亡。
结论：这些数据支持支气管热成形术的安全性并提示长期有效性。
(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)
(QJM. 2017 Nov 15. doi: 10.1093/qjmed/hcx221. [Epub ahead of print])
(QJM. 2017 Nov 15. doi: 10.1093/qjmed/hcx221. [Epub ahead of print])
The efficacy and safety of Bronchial Thermoplasty in Severe Persistent Asthma on extended follow-up.
O'Reilly A1, Browne I1, Watchorn D1, Egan JJ2, Lane S1,3.
Abstract
BACKGROUND:Asthma is a common condition and there remains a subset of patients who are poorly controlled on maximal therapy. Bronchial thermoplasty is a bronchoscopic therapy using radio frequency energy to reduce airway smooth muscle which has been shown to improve asthma control although further evidence regarding long term efficacy and safety is required. We aimed to demonstrate safety and efficacy of bronchial thermoplasty on extended follow up. Our initial experience with this group was previously reported in 2016 where patients were shown to have a significant improvement in Asthma Control Test (ACT) scores 1 year post treatment8.
METHODS:We carried out a retrospective observational study of 7 patients who underwent bronchial thermoplasty between 2012 and 2013 in an Irish severe asthma centre. The primary endpoint was change in ACT scores from baseline to present. Seven patients underwent bronchial thermoplasty at a tertiary referral centre in Ireland. Asthma Control Test scores and data on hospital admissions, exacerbations, maintenance corticosteroid requirements, rescue bronchodilator use and FEV1 prior to the procedure and on extended follow up were collected. Mean follow up was 49.42 months.
RESULTS:A trend towards improvement was seen in median hospitalisations (respective values for median over 12 months 3, 1 p = 0.059) and Asthma Control Test scores, from 9 to 13 (p = 0.249). Mean FEV1 was 1.68L prior to treatment and 1.46L 4 years post treatment (p = 0.237). There was no mortality among the group.
CONCLUSIONS:These data support the safety of bronchial thermoplasty and suggest extended efficacy.
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噻托溴铵呼吸道附加物在症状性哮喘中有效，不依赖于T2表型
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奥玛珠单抗治疗中度至重度过敏性哮喘患者的报告结果：随机对照试验的系统回顾
