预测普通感冒后的哮喘控制恶化
2009/03/10
关键词：哮喘；哮喘控制；普通感冒
哮喘患者对普通感冒反映变异较大，早期特征可能提示哮喘控制的恶化。为了识别这些特征，Walter等对413例成人哮喘患者进行了前瞻性的多中心队列研究。
研究使用迷你哮喘控制问卷（mini-Asthma Control Questionnaire， mini-ACQ）评价哮喘控制变化，使用Wisconsin上呼吸道症状调查-21（Wisconsin Upper Respiratory Symptom Survey-21，WURSS-21）评估感冒的严重度；应用单因素和多因素模型分析人口统计学、生理学、血清学和感冒相关特征与哮喘控制变化的关系。
研究发现，感冒后哮喘控制情况明显恶化(mini-ACQ评分升高0.69±0.93)，单因素分析提示季节、感冒持续时间和感冒严重度与哮喘控制变化有关。多因素分析感冒2天内的协变量发现，第2天和2天内累计WURSS-21评分对于预测哮喘控制的变化非常有意义。
综合研究结果，作者认为，哮喘患者前2天的感冒严重度可以用来预测哮喘控制的变化，这些信息有助于临床医生防治感冒后的哮喘恶化。
（韩伟 青岛大学医学院附属青岛市市立医院呼吸科 266071 摘译）
（Eur Respir J 2008; 32:1548-1554）
Eur Respir J 2008; 32:1548-1554
Predicting worsening asthma control following the common cold
M. J. Walter, M. Castro, S. J. Kunselman, 等
Keywords: Asthma, asthma control, common cold
The asthmatic response to the common cold is highly variable, and early characteristics that predict worsening of asthma control following a cold have not been identified.
In this prospective multicentric cohort study of 413 adult subjects with asthma, the mini-Asthma Control Questionnaire (mini-ACQ) was used to quantify changes in asthma control and the Wisconsin Upper Respiratory Symptom Survey-21 (WURSS-21) to measure cold severity. Univariate and multivariable models were used to examine demographic, physiological, serological and cold-related characteristics for their relationship to changes in asthma control following a cold.
Clinically significant worsening of asthma control was observed following a cold (mean±SD increase in mini-ACQ score of 0.69±0.93). Univariate analysis demonstrated that season, centre location, cold duration and cold severity measurements were all associated with a change in asthma control. Multivariable analysis of the covariates available within the first 2 days of cold onset revealed that the day 2 and cumulative sum of day 1 and 2 WURSS-21 scores were significant predictors of the subsequent changes in asthma control.
In asthmatic subjects, cold severity within the first 2 days can be used to predict subsequent changes in asthma control. This information may help clinicians prevent deterioration in asthma control following a cold.
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哮喘患者接受抗炎平喘治疗后仍存在气流受限、气道狭窄
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低龄儿童喘息和气道高反应性作为年轻人新诊断哮喘的预测因素：一项纵向出生队列研究
