高原治疗严重过敏性和非过敏性哮喘
2012/05/08
高原治疗哮喘的一个优势是避免过敏原暴露。近期研究显示，高原治疗哮喘能改善非过敏性哮喘患者的气道炎症。我们认为高原治疗严重难治性过敏性或非过敏性哮喘，疗效与平原类似。在一项前瞻性观察性队列研究中，连续入选137名在达沃斯（1600 m）接受哮喘治疗的严重难治性哮喘患者（92名为过敏性哮喘患者）。检测入院后和治疗12周后的哮喘控制（ACQ）、哮喘相关生活质量（AQLQ）、鼻-鼻窦症状（SNOT-20）、用药需求和支气管扩张剂使用后的FEV1（pb FEV1）、6分钟行走距离（6MWD）、总IgE、血液嗜酸性粒细胞和呼出气一氧化氮（FeNO）。过敏性和非过敏性哮喘患者具有相似的ACQ（-1.4和-1.5; p=0.79）、AQLQ（1.6和1.5; p=0.94）、SNOT-20（-0.7和-0.5; p=0.18）、pbFEV1（6.1%和5.8% pred.; p=0.87）、6MWD（+125 m and +147 m; p=0.43）和口服激素（40% vs 44%; p=0.51）改善程度。过敏性哮喘患者总IgE、血液嗜酸性粒细胞和FeNO下降更为明显。不管是否为过敏性哮喘，高原治疗哮喘能改善严重难治性哮喘患者的哮喘临床和功能参数，减少口服激素的需求。
（苏楠 审校）
Eur Respir J. 2012 Mar 22. [Epub ahead of print]
Eur Respir J. 2012 Mar 22. [Epub ahead of print]
Source
Davos, Switzerland.
Abstract
The beneficial effects of high altitude treatment in asthma have been attributed to allergen avoidance. Recent evidence shows that this treatment improves airway inflammation in non-allergic patients as well. We hypothesized that high altitude treatment is clinically equally effective in patients with severe refractory asthma, with or without allergic sensitization. In a prospective observational cohort study, 137 adults with severe refractory asthma (92 with allergic sensitization), referred for high altitude treatment in Davos (1600 m) were consecutively included. We measured asthma control (ACQ), asthma-related quality of life (AQLQ), sino-nasal symptoms (SNOT-20), medication requirement, post bronchodilator (pb)FEV1, 6 min. walking distance (6MWD), total IgE, blood eosinophils, and exhaled nitric oxide (FeNO) at admittance and after 12 weeks. Sensitized and non-sensitized patients showed similar improvements in ACQ (-1.4 and -1.5; p=0.79), AQLQ (1.6 and 1.5; p=0.94), SNOT-20 (-0.7 and -0.5; p=0.18), pbFEV1 (6.1% and 5.8% pred.; p=0.87), 6MWD (+125 m and +147 m; p=0.43) and oral steroids (40% vs 44%; p=0.51). Sensitized patients showed a larger decrease in total IgE, blood eosinophils and FeNO. High altitude treatment improves clinical and functional parameters, and decreases oral corticosteroid requirement in patients with severe
refractory asthma, irrespective of allergic sensitization.
Eur Respir J. 2012 Mar 22. [Epub ahead of print]
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哮喘未控制患者由沙美特罗/氟替卡松向福莫特罗/布地奈德转换后的疗效
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奥玛珠单抗辅助治疗的严重过敏性哮喘患者的哮喘相关生活质量：来自巴西的研究(QUALITX)
