重度哮喘患者中过敏性支气管肺曲霉病的患病率更高吗？
2024/09/29
摘要
背景：过敏性支气管肺曲霉病（ABPA）被认为在重度哮喘中比轻度哮喘更常见。然而，没有精确的数据支持这一假设。
目的：确定不同哮喘严重程度受试者中ABPA的患病率。
方法：我们对根据2004年全球哮喘倡议指南分类的543名成人哮喘受试者的前瞻性收集数据进行了二次分析。哮喘严重程度分为轻度、中度和重度。我们报告了ABPA在每种哮喘类别中的患病率。我们还进行了多变量逻辑回归分析，以确定与哮喘受试者ABPA相关的因素。
结果：我们将81名（15%）、257名（47%）和205名（38%）受试者分为轻度、中度和重度哮喘。我们在106名（19.5%）受试者中诊断出ABPA。轻度哮喘的ABPA患病率为11.1%（9/81），中度哮喘为21%（54/257），重度哮喘为20.7%（43/205）（p=0.12）。多变量分析确定年龄和哮喘持续时间是与ABPA相关的重要因素，而哮喘严重程度没有显著相关性。
结论：ABPA的患病率与哮喘的严重程度没有显著差异。这些发现支持国际人类和动物真菌学学会ABPA工作组修订后的建议，即筛查所有哮喘患者的ABPA，无论哮喘严重程度如何。有必要在不同地理区域进行进一步的大规模研究，以验证这些发现。
Is the prevalence of allergic bronchopulmonary aspergillosis greater in severe asthma?
Inderpaul Singh Sehgal, Puneet Saxena, Sahajal Dhooria, Valliappan Muthu, Soundappan Kathirvel, Kuruswamy Thurai Prasad, Mandeep Garg, Shivaprakash Mandya Rudramurthy, Ashutosh Nath Aggarwal, Arunaloke Chakrabarti, Ritesh Agarwal
Abstract
Background: Allergic bronchopulmonary aspergillosis (ABPA) is thought to occur more frequently in severe than in mild asthma. However, there is no precise data to support this hypothesis.
Objective: To determine the prevalence of ABPA in subjects with varying asthma severity.
Methods: We conducted a secondary analysis of prospectively collected data from 543 adult asthma subjects classified according to the 2004 Global Initiative for Asthma guidelines. The asthma severity was categorized into mild, moderate, and severe. We report the prevalence of ABPA in each asthma category. We also performed multivariable logistic regression analysis to identify factors associated with ABPA in subjects with asthma.
Results: We classified 81 (15%), 257 (47%), and 205 (38%) subjects as mild, moderate, and severe asthma. We diagnosed ABPA in 106 (19.5%) subjects. The prevalence of ABPA was 11.1% (9/81) in mild, 21% (54/257) in moderate, and 20.7% (43/205) in severe asthma (p=0.12). Multivariable analysis identified age and asthma duration as significant factors associated with ABPA, whereas asthma severity was not significantly associated.
Conclusion: The prevalence of ABPA does not vary significantly with the severity of asthma. These findings support the revised International Society of Human and Animal Mycology ABPA working group recommendation for screening all asthma patients for ABPA, irrespective of asthma severity. Further large-scale studies across different geographic regions are warranted to validate these findings.
背景：过敏性支气管肺曲霉病（ABPA）被认为在重度哮喘中比轻度哮喘更常见。然而，没有精确的数据支持这一假设。
目的：确定不同哮喘严重程度受试者中ABPA的患病率。
方法：我们对根据2004年全球哮喘倡议指南分类的543名成人哮喘受试者的前瞻性收集数据进行了二次分析。哮喘严重程度分为轻度、中度和重度。我们报告了ABPA在每种哮喘类别中的患病率。我们还进行了多变量逻辑回归分析，以确定与哮喘受试者ABPA相关的因素。
结果：我们将81名（15%）、257名（47%）和205名（38%）受试者分为轻度、中度和重度哮喘。我们在106名（19.5%）受试者中诊断出ABPA。轻度哮喘的ABPA患病率为11.1%（9/81），中度哮喘为21%（54/257），重度哮喘为20.7%（43/205）（p=0.12）。多变量分析确定年龄和哮喘持续时间是与ABPA相关的重要因素，而哮喘严重程度没有显著相关性。
结论：ABPA的患病率与哮喘的严重程度没有显著差异。这些发现支持国际人类和动物真菌学学会ABPA工作组修订后的建议，即筛查所有哮喘患者的ABPA，无论哮喘严重程度如何。有必要在不同地理区域进行进一步的大规模研究，以验证这些发现。
(中日友好医院呼吸与危重症医学科 李红雯 摘译 林江涛 审校)
(J Allergy Clin Immunol Pract. 2024 Sep 10:S2213-2198(24)00890-0. doi: 10.1016/j.jaip.2024.09.002.)
(J Allergy Clin Immunol Pract. 2024 Sep 10:S2213-2198(24)00890-0. doi: 10.1016/j.jaip.2024.09.002.)
Is the prevalence of allergic bronchopulmonary aspergillosis greater in severe asthma?
Inderpaul Singh Sehgal, Puneet Saxena, Sahajal Dhooria, Valliappan Muthu, Soundappan Kathirvel, Kuruswamy Thurai Prasad, Mandeep Garg, Shivaprakash Mandya Rudramurthy, Ashutosh Nath Aggarwal, Arunaloke Chakrabarti, Ritesh Agarwal
Abstract
Background: Allergic bronchopulmonary aspergillosis (ABPA) is thought to occur more frequently in severe than in mild asthma. However, there is no precise data to support this hypothesis.
Objective: To determine the prevalence of ABPA in subjects with varying asthma severity.
Methods: We conducted a secondary analysis of prospectively collected data from 543 adult asthma subjects classified according to the 2004 Global Initiative for Asthma guidelines. The asthma severity was categorized into mild, moderate, and severe. We report the prevalence of ABPA in each asthma category. We also performed multivariable logistic regression analysis to identify factors associated with ABPA in subjects with asthma.
Results: We classified 81 (15%), 257 (47%), and 205 (38%) subjects as mild, moderate, and severe asthma. We diagnosed ABPA in 106 (19.5%) subjects. The prevalence of ABPA was 11.1% (9/81) in mild, 21% (54/257) in moderate, and 20.7% (43/205) in severe asthma (p=0.12). Multivariable analysis identified age and asthma duration as significant factors associated with ABPA, whereas asthma severity was not significantly associated.
Conclusion: The prevalence of ABPA does not vary significantly with the severity of asthma. These findings support the revised International Society of Human and Animal Mycology ABPA working group recommendation for screening all asthma patients for ABPA, irrespective of asthma severity. Further large-scale studies across different geographic regions are warranted to validate these findings.
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