使用问卷调查分析年龄、性别及疾病严重程度对支气管哮喘患者吸入性糖皮质激素选择的影响
2009/07/09
背景：吸入糖皮质激素治疗（ICS）在哮喘治疗中具有重要作用。虽然目前有多种吸入性糖皮质激素制剂可供选择，但未见有ICS选择策略的报道。
方法：根据尼加答哮喘治疗研究小组于2004年对哮喘治疗进行的相关问卷调查，我们研究了患者与基于患者个体情况的ICS选择、哮喘控制和治疗之间的关系，分析医生选择ICS治疗的特征。
结果：共有2852个病例，2279人（79.9%）为ICS使用者，其中1513人（66.4%的ICS使用者）采用丙酸氟替卡松（FP）治疗，438人（19.2%）采用布地奈德（BUD）治疗，240人（10.5%）采用氢氟烷-倍氯米松（HFA-BDP）治疗。结果显示，FP为本研究中的标准ICS。与FP组（55.8±16.6）相比，BUD组平均年龄明显偏低（52.3±18.2岁），而HFA-BDP 组年龄偏大（59.9±17.0岁）。与FP组（51.1%）相比，BUD组女性患者所占比率较大（59.0%），而HFA-BDP组与其无显著性差异（46.5%）。上述结果表明，与FP组相比，较多年轻女性使用BUD，而HFA-BDP一般用于年长者，且与性别无关。
结论：本研究显示，基于患者个性特征，ICS合理的运用于每位受调查患者。随着新的ICS及吸入装置的出现，我们有必要进一步研究哮喘治疗中ICS选择的特点。
（林江涛 审校）
Allergol Int. 2009 May 25;58(3). [Epub ahead of print]
Analysis of Inhaled Corticosteroid Selection in Patients with Bronchial Asthma Using a Questionnaire Survey -Effects of Age, Gender, and Disease Severity-
Ota K, Hasegawa T, Koya T, Sakagami T, Sekikawa T, Toyabe S, Akazawa K, Arakawa M, Gejyo F, Suzuki E.
Division of Respiratory Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
Background: Inhaled corticosteroid (ICS) has played an important role in the management of asthma. Although several kinds of ICSs are currently available, there is no established strategy for ICS selection.
Methods: Using the data from the 2004 questionnaire surveys by the Niigata Asthma Treatment Study Group, we analyzed relationships between each patient and the ICS employed on the basis of patient background, asthma control and treatment, and indicated characteristics of ICS selection by the physician.
Results: Of 2852 cases, 2279 (79.9%) were ICS users, and 1513 (66.4% of ICS users) were classified as being in the fluticasone propionate (FP) group, 438 (19.2%) in the budesonide (BUD) group, and 240 (10.5%) in the hydrofluoroalkane-beclometasone (HFA-BDP) group, indicating that FP was a standard ICS in this study. The mean age was significantly lower in the BUD group (52.3+/-18.2 years) and was significantly higher in the HFA-BDP group (59.9+/-17.0 years) than that in the FP group (55.8+/-16.6 yaers). The proportion of female patients was significantly higher not in the HFA-BDP (46.5%) but in the BUD group (59.0%) than in the FP group (51.1%). These results indicated that BUD was frequently prescribed to young female and HFA-BDP was employed in the elderly patients irrespective of gender compared with FP.
Conclusions: Our study indicates that ICS selection is reasonably adapted to each patient’s background at least in the surveyed area. We need to elucidate the characteristics of ICS selection further in the future as new ICS and devices are developed.
方法：根据尼加答哮喘治疗研究小组于2004年对哮喘治疗进行的相关问卷调查，我们研究了患者与基于患者个体情况的ICS选择、哮喘控制和治疗之间的关系，分析医生选择ICS治疗的特征。
结果：共有2852个病例，2279人（79.9%）为ICS使用者，其中1513人（66.4%的ICS使用者）采用丙酸氟替卡松（FP）治疗，438人（19.2%）采用布地奈德（BUD）治疗，240人（10.5%）采用氢氟烷-倍氯米松（HFA-BDP）治疗。结果显示，FP为本研究中的标准ICS。与FP组（55.8±16.6）相比，BUD组平均年龄明显偏低（52.3±18.2岁），而HFA-BDP 组年龄偏大（59.9±17.0岁）。与FP组（51.1%）相比，BUD组女性患者所占比率较大（59.0%），而HFA-BDP组与其无显著性差异（46.5%）。上述结果表明，与FP组相比，较多年轻女性使用BUD，而HFA-BDP一般用于年长者，且与性别无关。
结论：本研究显示，基于患者个性特征，ICS合理的运用于每位受调查患者。随着新的ICS及吸入装置的出现，我们有必要进一步研究哮喘治疗中ICS选择的特点。
（林江涛 审校）
Allergol Int. 2009 May 25;58(3). [Epub ahead of print]
Analysis of Inhaled Corticosteroid Selection in Patients with Bronchial Asthma Using a Questionnaire Survey -Effects of Age, Gender, and Disease Severity-
Ota K, Hasegawa T, Koya T, Sakagami T, Sekikawa T, Toyabe S, Akazawa K, Arakawa M, Gejyo F, Suzuki E.
Division of Respiratory Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
Background: Inhaled corticosteroid (ICS) has played an important role in the management of asthma. Although several kinds of ICSs are currently available, there is no established strategy for ICS selection.
Methods: Using the data from the 2004 questionnaire surveys by the Niigata Asthma Treatment Study Group, we analyzed relationships between each patient and the ICS employed on the basis of patient background, asthma control and treatment, and indicated characteristics of ICS selection by the physician.
Results: Of 2852 cases, 2279 (79.9%) were ICS users, and 1513 (66.4% of ICS users) were classified as being in the fluticasone propionate (FP) group, 438 (19.2%) in the budesonide (BUD) group, and 240 (10.5%) in the hydrofluoroalkane-beclometasone (HFA-BDP) group, indicating that FP was a standard ICS in this study. The mean age was significantly lower in the BUD group (52.3+/-18.2 years) and was significantly higher in the HFA-BDP group (59.9+/-17.0 years) than that in the FP group (55.8+/-16.6 yaers). The proportion of female patients was significantly higher not in the HFA-BDP (46.5%) but in the BUD group (59.0%) than in the FP group (51.1%). These results indicated that BUD was frequently prescribed to young female and HFA-BDP was employed in the elderly patients irrespective of gender compared with FP.
Conclusions: Our study indicates that ICS selection is reasonably adapted to each patient’s background at least in the surveyed area. We need to elucidate the characteristics of ICS selection further in the future as new ICS and devices are developed.
