3年随访观察重症哮喘病情恶化的预测因子
2018/08/16
摘要
背景：急性发作的易感性被认为是一种独特的表型称之为“前期恶化”，表示其与哮喘急性加重有最强的临床相关因素。 因此，为了研究与哮喘急性发作相关的其他新型生物标志物，必须将“既往恶化状态”作为混杂因素。
目的：本研究旨在探讨严重哮喘急性发作相关的临床和生物标志物特征。
方法：我们连续三年评估了105名重症哮喘患者的临床参数，以及他们的恶化状态。我们将受试者分为三组：1）一致的非加重者（CNE，在三年期间未发生任何恶化的受试者）; 2）持续频繁的加重者（CFE，频繁发作的受试者，定义为在一年内发生两次或更多次急性加重的患者;3）间歇性加重者（IE）。我们进行了多变量分析，用于多组因素之间的比较，包括几种与Th2相关的生物标志物，以及“既往恶化状态”。
结果：39名受试者被归类为CNE，15名被归类为CFE，51名被归类为IE。 上一年的频繁加重预示着下一年的加重（P <0.001）。在几种与Th2相关的生物标志物中，只有FeNO与恶化状态有关。当我们分析第二次访视后的数据时，即使考虑到第一年的恶化状态，FeNO对预测未来恶化的影响仍然起着显著作用（P <0.05）。
总结：FeNO的测量对预测未来哮喘急性加重有显著作用，这与“既往急性加重史”无关。
3 Prospective predictors of exacerbation status in severe asthma over a 3-year follow-up.
Kimura H, et al. Clin Exp Allergy. 2018 May 21.
Abstract
Background：A predisposition to exacerbations is being recognized as a distinct phenotype with "previous exacerbations" representing the strongest clinical factor associated with future exacerbation. Thus, to identify additional novel biomarkers associated with asthma exacerbations, "past exacerbation status" must be included as a confounding factor.
Objective：This study aimed to characterize the clinical and biomarker features associated with asthma exacerbations in severe asthma.
Methods：We evaluated clinical parameters from 105 severe asthmatics yearly for 3 years, as well as their exacerbation status. We classified the subjects into three groups: 1) consistent non-exacerbators (CNE, subjects who did not experience any exacerbation over the three-year period); 2) consistent frequent exacerbators (CFE, subjects with frequent exacerbation, defined as those who had two or more exacerbations within one year, throughout the three-year period; and 3) intermittent exacerbators (IE). We conducted multivariate analysis for comparisons among the groups for multiple factors, including several Th2-related biomarkers, in addition to the "past exacerbation status."
Results：39 subjects were classified as CNE, 15 as CFE, and 51 as IE. Frequent exacerbations in the previous year predicted exacerbations for the following year (P < 0.001). Among the several Th2-related biomarkers, only FeNO was associated with exacerbation status. When we analyzed the data after the second visit, the impact of FeNO on predicting future exacerbation remained significant, even after considering the exacerbation status during the first year (P < 0.05).
Conclusion：Measurement of FeNO has a significant potential to predict future asthma exacerbation, which is independent of the "past exacerbation history".
背景：急性发作的易感性被认为是一种独特的表型称之为“前期恶化”，表示其与哮喘急性加重有最强的临床相关因素。 因此，为了研究与哮喘急性发作相关的其他新型生物标志物，必须将“既往恶化状态”作为混杂因素。
目的：本研究旨在探讨严重哮喘急性发作相关的临床和生物标志物特征。
方法：我们连续三年评估了105名重症哮喘患者的临床参数，以及他们的恶化状态。我们将受试者分为三组：1）一致的非加重者（CNE，在三年期间未发生任何恶化的受试者）; 2）持续频繁的加重者（CFE，频繁发作的受试者，定义为在一年内发生两次或更多次急性加重的患者;3）间歇性加重者（IE）。我们进行了多变量分析，用于多组因素之间的比较，包括几种与Th2相关的生物标志物，以及“既往恶化状态”。
结果：39名受试者被归类为CNE，15名被归类为CFE，51名被归类为IE。 上一年的频繁加重预示着下一年的加重（P <0.001）。在几种与Th2相关的生物标志物中，只有FeNO与恶化状态有关。当我们分析第二次访视后的数据时，即使考虑到第一年的恶化状态，FeNO对预测未来恶化的影响仍然起着显著作用（P <0.05）。
总结：FeNO的测量对预测未来哮喘急性加重有显著作用，这与“既往急性加重史”无关。
（复旦大学附属中山医院呼吸内科 包晨 摘译 杨冬 审校）
（Kimura H, et al. Clin Exp Allergy. 2018 May 21.）
（Kimura H, et al. Clin Exp Allergy. 2018 May 21.）
3 Prospective predictors of exacerbation status in severe asthma over a 3-year follow-up.
Kimura H, et al. Clin Exp Allergy. 2018 May 21.
Abstract
Background：A predisposition to exacerbations is being recognized as a distinct phenotype with "previous exacerbations" representing the strongest clinical factor associated with future exacerbation. Thus, to identify additional novel biomarkers associated with asthma exacerbations, "past exacerbation status" must be included as a confounding factor.
Objective：This study aimed to characterize the clinical and biomarker features associated with asthma exacerbations in severe asthma.
Methods：We evaluated clinical parameters from 105 severe asthmatics yearly for 3 years, as well as their exacerbation status. We classified the subjects into three groups: 1) consistent non-exacerbators (CNE, subjects who did not experience any exacerbation over the three-year period); 2) consistent frequent exacerbators (CFE, subjects with frequent exacerbation, defined as those who had two or more exacerbations within one year, throughout the three-year period; and 3) intermittent exacerbators (IE). We conducted multivariate analysis for comparisons among the groups for multiple factors, including several Th2-related biomarkers, in addition to the "past exacerbation status."
Results：39 subjects were classified as CNE, 15 as CFE, and 51 as IE. Frequent exacerbations in the previous year predicted exacerbations for the following year (P < 0.001). Among the several Th2-related biomarkers, only FeNO was associated with exacerbation status. When we analyzed the data after the second visit, the impact of FeNO on predicting future exacerbation remained significant, even after considering the exacerbation status during the first year (P < 0.05).
Conclusion：Measurement of FeNO has a significant potential to predict future asthma exacerbation, which is independent of the "past exacerbation history".
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第一次病毒感染引发喘息发作4年后肺功能及气道反应性变化
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哮喘控制，肺功能，营养状况和与健康相关的生活质量：成年男性和女性哮喘之间的差异
