儿童联合吸入糖皮质激素和长效β受体激动剂和重症监护室住院风险
2012/07/06
摘要
目的：长效β受体激动剂（LABA）与严重哮喘发作（包括死亡）间的关系仍然存在分歧。本试验为病例-对照研究，研究儿童LABA与激素吸入（ICS）联合治疗是否能增加近乎致命性哮喘的风险。
方法：对2005年UPMC匹兹堡儿童医院出现哮喘发作的4～18岁儿童的病历进行回顾分析。病例和对照分别在儿科重症监护室（PICU）和普通病房，比较LABA联合ICS与ICS单独治疗。
结果：85名患儿入住PICU，96名患儿普通病房治疗。与单独ICS治疗组相比，LABA联合ICS治疗并未增加PICU的入院风险（OD：1.07, 95% CI 0.46-2.52）。在对人口统计学、哮喘严重程度、PICU入院史校正后，与单独ICS治疗组相比，LABA/ICS并未增加PICU的入院风险（OD：0.84, 95% CI 0.26-2.76）。整个研究期内无死亡患者，5名患者行气管插管。
结论：LABA联合ICS并不会增加儿童近乎致死性哮喘风险。
(林江涛 审校)
J Asthma. 2012 Apr 30. [Epub ahead of print]
Long-Acting Beta-Agonists and the Risk of Intensive Care Unit Admission in Children.
Jacobs TS, Jones BL, Macginnitie AJ.
Source
Department of Pediatrics, Children’s Hospital of Pittsburgh of UPMC , Pittsburgh, PA , USA.
Abstract
OBJECTIVE：A possible association between long-acting beta-agonists (LABA) and severe asthma exacerbations including death remains controversial. We examined whether LABA in the setting of combination therapy with inhaled corticosteroids (ICS) increase the risk of near-fatal asthma in children using a case-control study design.
METHODS：Medical records from admissions for asthma exacerbations in children 4-18 years of age during the 2005 calendar year at Children’s Hospital of Pittsburgh of UPMC were reviewed. Cases and controls were determined by pediatric intensive care unit (PICU) and floor admission, respectively. Exposure was defined by LABA use in combination with ICS versus ICS alone.
RESULTS：Records from 85 PICU and 96 pediatric floor admissions were reviewed. LABA use in combination with ICS did not increase the risk of PICU admission (odds ratio 1.07, 95% CI 0.46-2.52) compared to ICS only without LABA. After adjusting for demographics, asthma severity, history of PICU admissions, and concurrent infection, LABA/ICS use still did not increase the risk of PICU admission (adjusted odds ratio 0.84, 95% CI 0.26-2.76) compared to ICS alone. There were no deaths and five intubations within the study period.
CONCLUSIONS：The combination of LABA and ICS did not appear to increase the risk of near-fatal asthma in children.
J Asthma. 2012 Apr 30. [Epub ahead of print]
目的：长效β受体激动剂（LABA）与严重哮喘发作（包括死亡）间的关系仍然存在分歧。本试验为病例-对照研究，研究儿童LABA与激素吸入（ICS）联合治疗是否能增加近乎致命性哮喘的风险。
方法：对2005年UPMC匹兹堡儿童医院出现哮喘发作的4～18岁儿童的病历进行回顾分析。病例和对照分别在儿科重症监护室（PICU）和普通病房，比较LABA联合ICS与ICS单独治疗。
结果：85名患儿入住PICU，96名患儿普通病房治疗。与单独ICS治疗组相比，LABA联合ICS治疗并未增加PICU的入院风险（OD：1.07, 95% CI 0.46-2.52）。在对人口统计学、哮喘严重程度、PICU入院史校正后，与单独ICS治疗组相比，LABA/ICS并未增加PICU的入院风险（OD：0.84, 95% CI 0.26-2.76）。整个研究期内无死亡患者，5名患者行气管插管。
结论：LABA联合ICS并不会增加儿童近乎致死性哮喘风险。
(林江涛 审校)
J Asthma. 2012 Apr 30. [Epub ahead of print]
Long-Acting Beta-Agonists and the Risk of Intensive Care Unit Admission in Children.
Jacobs TS, Jones BL, Macginnitie AJ.
Source
Department of Pediatrics, Children’s Hospital of Pittsburgh of UPMC , Pittsburgh, PA , USA.
Abstract
OBJECTIVE：A possible association between long-acting beta-agonists (LABA) and severe asthma exacerbations including death remains controversial. We examined whether LABA in the setting of combination therapy with inhaled corticosteroids (ICS) increase the risk of near-fatal asthma in children using a case-control study design.
METHODS：Medical records from admissions for asthma exacerbations in children 4-18 years of age during the 2005 calendar year at Children’s Hospital of Pittsburgh of UPMC were reviewed. Cases and controls were determined by pediatric intensive care unit (PICU) and floor admission, respectively. Exposure was defined by LABA use in combination with ICS versus ICS alone.
RESULTS：Records from 85 PICU and 96 pediatric floor admissions were reviewed. LABA use in combination with ICS did not increase the risk of PICU admission (odds ratio 1.07, 95% CI 0.46-2.52) compared to ICS only without LABA. After adjusting for demographics, asthma severity, history of PICU admissions, and concurrent infection, LABA/ICS use still did not increase the risk of PICU admission (adjusted odds ratio 0.84, 95% CI 0.26-2.76) compared to ICS alone. There were no deaths and five intubations within the study period.
CONCLUSIONS：The combination of LABA and ICS did not appear to increase the risk of near-fatal asthma in children.
J Asthma. 2012 Apr 30. [Epub ahead of print]
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哮喘患者体能训练
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中度-严重过敏性哮喘患者中奥玛珠单抗治疗与哮喘控制：6年的实用数据回顾
