中年哮喘患者对哮喘治疗指南的依从性分析
2010/08/20
随着全世界哮喘患者的增加，为促进哮喘治疗指南的改进和更新，Kandane-Rathnayake等人通过对TAHS (Tasmanian Longitudinal Health Study)研究的数据进行分析，以探讨适合中年哮喘患者的治疗方案。他们将近期TAHS研究中收集的中年哮喘患者（年龄在40～50岁）的呼吸功能、既往用药史和近期的哮喘严重程度分级等数据进行统计分析，其中收录的患者均有明确哮喘病史。
结果发现在纳入研究的702名哮喘患者中，50%有近期发作哮喘（n=351），其中71%为持续性哮喘（轻度n=98，中度n=92，重度n=58）。大多数的近期发作哮喘患者（85.2%）在最近12个月内曾应用过一种或多种平喘药物，但合理使用防治哮喘药物的比例较低（26%） 。部分病例在不合理的应用支气管扩张剂后出现气道阻塞加重导致哮喘持续状态加重的情况，但在合理用药时未出现此情况。由此可以看出，中年哮喘患者的合理用药，尤其是对有急性发作的中重度哮喘持续状态、且没有家族史的哮喘患者的合理用药的情况仍不尽人意。
RK等人用统计数据证实合理的预防用药可以有效防止肺功能下降和病情的进展，控制气道阻塞的发展，改善哮喘患者的生存质量和预后。
（于娜 沈阳中国医科大学附属一院 110001 摘译）
（Thorax 2009;64:1025-1031 doi:10.1136/thx.2009.118430）
（Thorax 2009;64:1025-1031 doi:10.1136/thx.2009.118430）
Adherence to asthma management guidelines by middle-aged adults with current asthma
2. M C Matheson1,
6. D Mészáros5,
7. R Wood-Baker5,
9. S Morrison7,
10. M A Jenkins1,
13. M J Abramson8,
14. S C Dharmage1,
Abstract
Background: With the increasing burden of asthma worldwide, much effort has been given to developing and updating management guidelines. Using data from the Tasmanian Longitudinal Health Study (TAHS), the adequacy of asthma management for middle-aged adults with asthma was investigated.
Methods: Information about spirometry, medication history and current asthma status was collected by the most recent TAHS when participants were in their mid 40s. Only those who reported ever having asthma were eligible for analysis.
Results: Of the 702 participants who reported ever having asthma, 50% had current asthma (n = 351) of whom 71% were categorised as having persistent asthma (n = 98 mild, n = 92 moderate, n = 58 severe). The majority (85.2%) of participants with current asthma had used some form of asthma medication in the past 12 months, but the proportion of the use of minimally adequate preventer medication was low (26%). Post-bronchodilator airflow obstruction increased progressively from mild to severe persistent asthma for those inadequately managed, but not for those on adequate therapy.
Conclusion: Appropriate use of asthma medication by this middle-aged group of adults with current asthma was inadequate, especially for those with adult-onset moderate or severe persistent disease and without a family history of asthma. These results suggest that proper use of preventer medication could protect against the progressive decline in lung function associated with increasing severity. This has implications not just for poor quality of life, but also for the development of fixed airflow obstruction.
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在哮喘模型中，简化中药干预治疗哮喘诱导的对过敏原的长期耐受，与γ干扰素而非转化生长因子β有关
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难治性哮喘儿童的激素反应和临床特征
