哮喘联盟

   摘要
   背景：有关哮喘急性发作、哮喘诱发因素与哮喘相关的生活质量(QoL)相关性的资料很少。
   目的：评估哮喘急性发作和哮喘诱发因素对QoL的影响。
   方法：本研究所纳入的年龄≥13岁的重度或难治性哮喘患者（n=2679）来自于TENOR（哮喘的流行病学和自然史：结果和治疗方案）3年观察研究。根据6个月和12个月的资料，将哮喘急性发作的严重程度从重到轻分为住院治疗、急诊治疗、糖皮质激素冲击治疗和无急性发作。对急性发作的总例数（频次）进行了评估。通过简易哮喘生活质量调查问卷(Mini-AQLQ)测评了哮喘相关的QoL；一年一次收集了基线水平的自我报告哮喘诱发因素。使用单向方差分析对哮喘急性发作严重程度的Mini-AQLQ得分、哮喘急性发作的总例数和哮喘诱发因素的数量进行了差异分析。
   结果：随着哮喘急性发作严重程度的增加（无急性发作、糖皮质激素冲击治疗、急诊治疗和住院治疗），Mini-AQLQ各维度和整体评分也显著逐渐降低(P< .001)：症状(5.5, 4.8, 4.3和4.2)、活动受限(5.8, 5.2, 4.6和4.4)、情感功能(5.6, 5.0, 4.4和4.2)、环境刺激(5.0, 4.5, 4.0和3.9)；整体(5.5, 4.9, 4.3和4.1)。急性发作频率的增加和基线哮喘诱发因素数目的增加也都与Mini-AQLQ评分的显著减少相关。哮喘诱发因素的增加与哮喘严重程度的增加及急性发作频率的增加相关。
   结论：远离哮喘诱发因素可能减低哮喘急性发作率，改善重度或难治性哮喘患者的与哮喘相关的QoL。该结论需要进一步的干预性研究加以证实。
 

（苏欣 审校）
JAllergyClinImmunolPract.2014Sep-Oct;2(5):544-552.e2.doi:10.1016/j.jaip.2014.02.011. Epub 2014 Jul 3.

 

Impact of Asthma Exacerbations and Asthma Triggers on Asthma-related Quality of Life in Patients with Severe or Difficult-to-Treat Asthma.
 

Luskin AT1, Chipps BE2, Rasouliyan L3, Miller DP3, Haselkorn T4, Dorenbaum A5.
 

ABSTRACT
BACKGROUND: Few data are available that evaluate the relationship among asthma exacerbations, asthma triggers, and asthma-related quality of life (QoL).
OBJECTIVE: To evaluate the impact of asthma exacerbations and asthma triggers on QoL.
METHODS: Patients with severe or difficult-to-treat asthma, ages ≥13 years (n = 2679) from the TENOR (The Epidemiology and Natural History of Asthma: Outcomes and Treatment Regimens) 3-year observational study were included. Exacerbations were defined hierarchically in descending order of severity (hospitalization, emergency department [ED] visit, steroid burst, no exacerbation) by using data from months 6 and 12. The total number (frequency) of exacerbations was assessed. Asthma-related QoL was measured at month 12 by using the Mini-Asthma QoL Questionnaire (Mini-AQLQ); self-reported asthma triggers were collected at baseline and annually. We used 1-way ANOVA to test for differences in Mini-AQLQ domain scores across asthma exacerbation severity, the total number of asthma exacerbations, and the number of asthma triggers.
RESULTS: A significant decrease (P < .001) in Mini-AQLQ domain scores was seen with increasing severity of asthma exacerbation (no exacerbation, steroid burst, ED visit, and hospitalization); symptom (5.5, 4.8, 4.3, and 4.2), activity (5.8, 5.2, 4.6, and 4.4), emotional (5.6, 5.0, 4.4, and 4.2), exposure (5.0, 4.5, 4.0, and 3.9); and overall (5.5, 4.9, 4.3, and 4.1). Increasing exacerbation frequency and the number of baseline asthma triggers also were associated with significant decreases in Mini-AQLQ domain scores. An increasing number of asthma triggers were associated with an increase in severity and frequency of exacerbations.
CONCLUSION: Avoidance of asthma triggers may reduce exacerbation rates and improve asthma-related QoL in patients with severe or difficult-to-treat asthma. Interventional studies are warranted to further explore these outcomes.
 

JAllergyClinImmunolPract.2014Sep-Oct;2(5):544-552.e2.doi:10.1016/j.jaip.2014.02.011. Epub 2014 Jul 3.