气道热整形术后一年哮喘观察
2007/04/13
气道热整形术是将一定能量通过支气管镜输入到气道内，通过热量降低气道平滑肌增殖，减轻气道收缩。本研究将入选112例中-重度哮喘患者。主要观察了哮喘发作频数，气道反应性，有症状天数和哮喘生活质量。气道热整形术降低了中度哮喘的发作，增加了晨起呼气峰流速，患者生存质量明显提高。
本研究结论为：气道热整形术可明显控制中-重度哮喘。
（刘颖格 西安,第四军医大学西京医院呼吸科 710032 摘译）
（N Engl J Med 2007;356:1327-37）
Asthma Control during the Year after Bronchial Thermoplasty
Gerard Cox, M.B., Neil C. Thomson, M.D., Adalberto S. Rubin, M.D., Robert M. Niven, M.D., Paul A. Corris, M.D., Hans Christian Siersted, M.D., Ronald Olivenstein, M.D., Ian D. Pavord, M.D., David McCormack, M.D., Rekha Chaudhuri, M.D., John D. Miller, M.D., Michel Laviolette, M.D., for the AIR Trial Study Group
ABSTRACT
Background：Bronchial thermoplasty is a bronchoscopic procedure to reduce the mass of airway smooth muscle and attenuate bronchoconstriction. We examined the effect of bronchial thermoplasty on the control of moderate or severe persistent asthma.
Methods：We randomly assigned 112 subjects who had been treated with inhaled corticosteroids and long-acting 
2-adrenergic agonists (LABA) and in whom asthma control was impaired when the LABA were withdrawn to either bronchial thermoplasty or a control group. The primary outcome was the frequency of mild exacerbations, calculated during three scheduled 2-week periods of abstinence from LABA at 3, 6, and 12 months. Airflow, airway responsiveness, asthma symptoms, the number of symptom-free days, use of rescue medication, and scores on the Asthma Quality of Life Questionnaire (AQLQ) and the Asthma Control Questionnaire (ACQ) were also assessed.
2-adrenergic agonists (LABA) and in whom asthma control was impaired when the LABA were withdrawn to either bronchial thermoplasty or a control group. The primary outcome was the frequency of mild exacerbations, calculated during three scheduled 2-week periods of abstinence from LABA at 3, 6, and 12 months. Airflow, airway responsiveness, asthma symptoms, the number of symptom-free days, use of rescue medication, and scores on the Asthma Quality of Life Questionnaire (AQLQ) and the Asthma Control Questionnaire (ACQ) were also assessed. Results：The mean rate of mild exacerbations, as compared with baseline, was reduced in the bronchial-thermoplasty group but was unchanged in the control group (change in frequency per subject per week, –0.16±0.37 vs. 0.04±0.29; P=0.005). At 12 months, there were significantly greater improvements in the bronchial-thermoplasty group than in the control group in the morning peak expiratory flow (39.3±48.7 vs. 8.5±44.2 liters per minute), scores on the AQLQ (1.3±1.0 vs. 0.6±1.1) and ACQ (reduction, 1.2±1.0 vs. 0.5±1.0), the percentage of symptom-free days (40.6±39.7 vs. 17.0±37.9), and symptom scores (reduction, 1.9±2.1 vs. 0.7±2.5) while fewer puffs of rescue medication were required. Values for airway responsiveness and forced expiratory volume in 1 second did not differ significantly between the two groups. Adverse events immediately after treatment were more common in the bronchial-thermoplasty group than in the control group but were similar during the period from 6 weeks to 12 months after treatment.
Conclusions：Bronchial thermoplasty in subjects with moderate or severe asthma results in an improvement in asthma control. (ClinicalTrials.gov number, NCT00214526)
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孟鲁司特对学龄前儿童气道高反应性的治疗作用
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NK1/NK2 受体拮抗剂对过敏原激发的哮喘气道反应性及炎症的作用研究
