不同联合吸入治疗的青少年哮喘患者气道高反应性
2012/07/06
摘要
背景：联合吸入治疗能改善哮喘患者的肺功能，但青少年哮喘患者中，该治疗对气道高反应性（AHR）的影响及不同药物联合治疗的疗效尚不清楚。
目的：在青少年哮喘患者中评价不同联合吸入治疗的治疗反应，评价其对运动诱发的AHR的影响。
方法：对30名患有过敏性哮喘的青少年（13～16岁，19名女性）进行基础肺功能检测（LFT）。随后进行运动激发测试（EC）和支气管扩张测试（BD）。4周时间内，15名青少年采用吸入氟替卡松/沙美特罗（A组）治疗，另15名采用吸入布地奈德/福莫特罗（B组）治疗。此后，以上述方式对肺功能进行评价。
结果：治疗前，两组肺功能相似。治疗4周后，基础LFT显著改善（FEV1：P = 0.001），运动诱发的支气管收缩下降（无显著性），对BD反应的恢复较小（A组和B组分别为P= 0.001和0.002）。B组患者的表现更佳：基础FEF 25/75显著改善（P= 0.001）、针对EC的支气管收缩反应下降（FEV1：P= 0.008）、针对BD检测的反应更小（FEV1：P=0.0001；FEF 25/75：P=0.024）。未观察到副作用。
结论：经过4周的联合吸入治疗，哮喘患者的肺功能和支气管收缩性得到改善。这些改善在布地奈德/福莫特罗组更明显。对于青少年哮喘患者，上述用药能安全的控制哮喘发作。
（刘国梁 审校）
Eur Ann Allergy Clin Immunol. 2012 Feb;44(1):12-7.
Eur Ann Allergy Clin Immunol. 2012 Feb;44(1):12-7.
Source
Coimbra University Hospitals, Immunoallergy Department, Coimbra, Portugal. danielmachadooliveira@gmail.com
Abstract
BACKGROUND: Inhaled combined therapy improves the pulmonary function in asthmatic patients. The effect on the airway hyperresponsiveness (AHR) and the efficacy of different pharmacological schedules is not well clarified on adolescent asthmatics.
OBJECTIVE: Evaluate the responses to different combined inhaled therapies in adolescent asthmatics and study its impact on exercise induced AHR.
METHODS: Basal lung function tests (LFT) were performed in 30 adolescents (13 to 16 years old; 19 female) with allergic asthma. They were submitted to exercise challenge test (EC) followed by bronchodilator test (BD). During 4 weeks, 15 adolescents were submitted to inhaled fluticasone/salmeterol (group A) and other 15 to inhaled budesonide/formoterol (group B). After this period, they underwent another functional evaluation as previous.
RESULTS: Before treatment, pulmonary function was similar in both groups. After 4 weeks of treatment, these groups showed an improvement of the basal LFT (p = 0.001 for FEV1 in both), decrease on bronchoconstriction induced by exercise (NS for both) and less recovery on BD response (p = 0.001 and 0.002, for FEV1 respectively groups A and B). Group B showed a better performance, with higher improvement of basal FEF 25/75 (p = 0.001), reduced bronchoconstriction response to EC (p = 0.008 for FEV1) and fewer response to BD test (p < 0.0001 for FEV1 and 0.024 for FEF 25/75) No adverse events were observed.
CONCLUSION: After 4 weeks of inhaled combined therapy, these patients improved their pulmonary function and bronchomotricity. Those under budesonide/formoterol showed the highest improvement. These medications are a safe measure in controlling the asthma in these patients.
Eur Ann Allergy Clin Immunol. 2012 Feb;44(1):12-7.
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他汀类药物是否能改善激素吸入治疗患者的哮喘转归：回顾性队列研究
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长效β2受体激动剂维兰特罗治疗持续性哮喘的疗效和最佳给药间隔：随机临床试验
