哮喘急性加重与重度嗜酸粒细胞性哮喘患者肺功能下降相关
2018/03/05
摘要
背景：哮喘急性发作频率与重症哮喘患者肺功能下降之间的关系证据有限。本文旨在确定哮喘急性发作是否与肺功能下降有关。
方法：回顾性分析来自重症哮喘患者美泊利单抗干预DREAM和MENSA研究数据的肺功能变化。患者为不吸烟或已戒烟者。使用线性回归模型来分析各治疗组间加重次数与FEV1下降之间的关系。
结果:在一项联合事后分析中，57％（n = 572）的患者没有急性发作，并且支气管扩张剂使用后FEV1提高了143 mL。相反，3次及以上急性发作的患者中，支气管扩张剂后FEV1降低了77mL。线性建模分析估计，观察期间每次急性发作，FEV1下降50 mL（P <0.001）。
结论：观察到重症嗜酸性粒细胞性哮喘患者急性加重次数与肺功能下降之间有直接关系。反复发作可能与加速肺功能丧失有关。
Asthma Exacerbations Associated with Lung Function Decline in Patients with Severe Eosinophilic Asthma.
Ortega H1, Yancey SW2, Keene ON3, Gunsoy NB3, Albers FC2, Howarth PH4.
Abstract
BACKGROUND:Limited data describe the association between the frequency of asthma exacerbations and the decline in lung function in severe asthma. To determine whether asthma exacerbations are associated with enhanced decline in lung function.
METHODS:Changes in lung function were analyzed retrospectively using data from the DREAM and MENSA studies of mepolizumab intervention in patients with severe asthma. Patients were either nonsmokers or former smokers. A linear regression model was used to analyze the relationship between the number of exacerbations and decline in FEV1 across treatment groups.
RESULTS:In a combined post hoc analysis, 57% (n = 572) of patients had no exacerbations and experienced an improvement in postbronchodilator FEV1 of 143 mL. In contrast, in patients who experienced 3 or more exacerbations, there was a decrease in postbronchodilator FEV1 of 77 mL in the combined analysis. The linear modeling analysis estimated that for each exacerbation seen during the observational period, there was a decrease of 50 mL in FEV1 (P < .001).
CONCLUSIONS:A direct relationship between the number of exacerbations in patients with severe eosinophilic asthma and decline in lung function was observed. Repeated exacerbations may be associated with accelerated loss of lung function.
背景：哮喘急性发作频率与重症哮喘患者肺功能下降之间的关系证据有限。本文旨在确定哮喘急性发作是否与肺功能下降有关。
方法：回顾性分析来自重症哮喘患者美泊利单抗干预DREAM和MENSA研究数据的肺功能变化。患者为不吸烟或已戒烟者。使用线性回归模型来分析各治疗组间加重次数与FEV1下降之间的关系。
结果:在一项联合事后分析中，57％（n = 572）的患者没有急性发作，并且支气管扩张剂使用后FEV1提高了143 mL。相反，3次及以上急性发作的患者中，支气管扩张剂后FEV1降低了77mL。线性建模分析估计，观察期间每次急性发作，FEV1下降50 mL（P <0.001）。
结论：观察到重症嗜酸性粒细胞性哮喘患者急性加重次数与肺功能下降之间有直接关系。反复发作可能与加速肺功能丧失有关。
(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 Allergy Clin Immunol Pract. 2018 Feb 1. pii: S2213-2198(18)30004-7.)
(J Allergy Clin Immunol Pract. 2018 Feb 1. pii: S2213-2198(18)30004-7.)
Asthma Exacerbations Associated with Lung Function Decline in Patients with Severe Eosinophilic Asthma.
Ortega H1, Yancey SW2, Keene ON3, Gunsoy NB3, Albers FC2, Howarth PH4.
Abstract
BACKGROUND:Limited data describe the association between the frequency of asthma exacerbations and the decline in lung function in severe asthma. To determine whether asthma exacerbations are associated with enhanced decline in lung function.
METHODS:Changes in lung function were analyzed retrospectively using data from the DREAM and MENSA studies of mepolizumab intervention in patients with severe asthma. Patients were either nonsmokers or former smokers. A linear regression model was used to analyze the relationship between the number of exacerbations and decline in FEV1 across treatment groups.
RESULTS:In a combined post hoc analysis, 57% (n = 572) of patients had no exacerbations and experienced an improvement in postbronchodilator FEV1 of 143 mL. In contrast, in patients who experienced 3 or more exacerbations, there was a decrease in postbronchodilator FEV1 of 77 mL in the combined analysis. The linear modeling analysis estimated that for each exacerbation seen during the observational period, there was a decrease of 50 mL in FEV1 (P < .001).
CONCLUSIONS:A direct relationship between the number of exacerbations in patients with severe eosinophilic asthma and decline in lung function was observed. Repeated exacerbations may be associated with accelerated loss of lung function.
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Transgelin-2作为哮喘治疗的新靶点
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焦虑，抑郁和哮喘控制：标准化治疗后的变化
