比较老年哮喘或老年非哮喘与年轻哮喘患者之间临床、生理和炎症特征
2018/05/03
摘要
背景：哮喘在老年人群中似乎是一种特殊表型，还有待进一步描述。在这篇前瞻性观察性研究中，我们旨在多维度测量老年人群中哮喘特征。
方法：在年轻（18至35岁）轻-中度哮喘患者和老年（年龄＞60岁）非哮喘或轻-中度哮喘患者中，我们比较三组的哮喘控制，医疗卫生保健及药物使用，肺功能，气道和全身炎症标志物，以及治疗依从性。
结果：每组均招募50例受试者。与年轻哮喘组和老年非哮喘组比较，老年哮喘组显示出更明显的气道阻塞。与年轻哮喘组比较，老年哮喘组哮喘控制更差，主要与更低FEV1相关，尽管两组间在气道反应性，卫生资源消耗，吸入激素的处方剂量以及用药依从性方面近似。相对于年轻哮喘组，老年哮喘组有一部分的全身炎症标志物升高，以及支气管上皮功能障碍。血嗜酸性粒细胞在两个哮喘组均升高，尤其是老年哮喘组。痰中性粒细胞在两个老年组中均升高，相对于其他两组，老年哮喘组痰嗜酸粒细胞升高。
结论：哮喘在老年人群中呈现出一种特殊表型，除了全身炎症反应，且与气道阻塞增加和混合气道炎症密切相关。
Comparative Clinical, Physiological, and Inflammatory Characteristics of Elderly Subjects With or Without Asthma and Young Subjects With Asthma
Louis-Philippe Boulet, MD, FCCP; Catherine Robitaille, MD; Francine Deschesnes, BSc; Hélène Villeneuve, BSc; and Marie-Ève Boulay, MSc
CHEST 2017; 152(6):1203-1213.
Abstract
BACKGROUND: Asthma seems to present in the elderly as a specific phenotype that remains to be further described. In this prospective observational study, we aimed to assess the multidimensional aspects of asthma in the elderly.
METHODS: In young (18 to 35 years old) subjects with mild to moderate asthma and elderly subjects (aged >60 years) either with or without mild to moderate asthma, we compared asthma control, health care and medication use, lung function, markers of airway and systemic inflammation, and adherence to therapy.
RESULTS: Fifty subjects were recruited in each group. Elderly people with asthma showed more marked airway obstruction compared with young people with asthma and elderly people without asthma. They also had poorer asthma control, mainly associated with a lower FEV1, compared with young people with asthma, although airway responsiveness, health care use, prescribed doses of inhaled corticosteroids, and adherence to treatment were similar in both groups. Elderly subjects had an increase in some markers of systemic inflammation and bronchial epithelial dysfunction compared with young people with asthma. Blood eosinophils were higher in both asthma groups, particularly in elderly people with asthma. Sputum neutrophils were increased in both groups of elderly subjects and sputum eosinophils were increased in elderly people with asthma compared with the other two groups.
CONCLUSIONS: Asthma in the elderly presents as a specific phenotype associated with increased airway obstruction and mixed airway inflammation in addition to signs of systemic inflammation.
背景：哮喘在老年人群中似乎是一种特殊表型，还有待进一步描述。在这篇前瞻性观察性研究中，我们旨在多维度测量老年人群中哮喘特征。
方法：在年轻（18至35岁）轻-中度哮喘患者和老年（年龄＞60岁）非哮喘或轻-中度哮喘患者中，我们比较三组的哮喘控制，医疗卫生保健及药物使用，肺功能，气道和全身炎症标志物，以及治疗依从性。
结果：每组均招募50例受试者。与年轻哮喘组和老年非哮喘组比较，老年哮喘组显示出更明显的气道阻塞。与年轻哮喘组比较，老年哮喘组哮喘控制更差，主要与更低FEV1相关，尽管两组间在气道反应性，卫生资源消耗，吸入激素的处方剂量以及用药依从性方面近似。相对于年轻哮喘组，老年哮喘组有一部分的全身炎症标志物升高，以及支气管上皮功能障碍。血嗜酸性粒细胞在两个哮喘组均升高，尤其是老年哮喘组。痰中性粒细胞在两个老年组中均升高，相对于其他两组，老年哮喘组痰嗜酸粒细胞升高。
结论：哮喘在老年人群中呈现出一种特殊表型，除了全身炎症反应，且与气道阻塞增加和混合气道炎症密切相关。
（王刚 张红萍 四川大学华西医院中西医结合科呼吸组）
（CHEST 2017; 152(6):1203-1213.）
（CHEST 2017; 152(6):1203-1213.）
Comparative Clinical, Physiological, and Inflammatory Characteristics of Elderly Subjects With or Without Asthma and Young Subjects With Asthma
Louis-Philippe Boulet, MD, FCCP; Catherine Robitaille, MD; Francine Deschesnes, BSc; Hélène Villeneuve, BSc; and Marie-Ève Boulay, MSc
CHEST 2017; 152(6):1203-1213.
Abstract
BACKGROUND: Asthma seems to present in the elderly as a specific phenotype that remains to be further described. In this prospective observational study, we aimed to assess the multidimensional aspects of asthma in the elderly.
METHODS: In young (18 to 35 years old) subjects with mild to moderate asthma and elderly subjects (aged >60 years) either with or without mild to moderate asthma, we compared asthma control, health care and medication use, lung function, markers of airway and systemic inflammation, and adherence to therapy.
RESULTS: Fifty subjects were recruited in each group. Elderly people with asthma showed more marked airway obstruction compared with young people with asthma and elderly people without asthma. They also had poorer asthma control, mainly associated with a lower FEV1, compared with young people with asthma, although airway responsiveness, health care use, prescribed doses of inhaled corticosteroids, and adherence to treatment were similar in both groups. Elderly subjects had an increase in some markers of systemic inflammation and bronchial epithelial dysfunction compared with young people with asthma. Blood eosinophils were higher in both asthma groups, particularly in elderly people with asthma. Sputum neutrophils were increased in both groups of elderly subjects and sputum eosinophils were increased in elderly people with asthma compared with the other two groups.
CONCLUSIONS: Asthma in the elderly presents as a specific phenotype associated with increased airway obstruction and mixed airway inflammation in addition to signs of systemic inflammation.
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对宠物的暴露和致敏能否改变内毒素与哮喘及喘息的关系
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对哮喘患者使用糖皮质激素治疗能通过STAT通路抑制哮喘患者ILC2频率和活性
