原标题:哮喘第一年治疗效果预测25年后治疗预后
——浙大迪迅 译
背景:本研究是一项对使用类固醇类药物治疗的成人哮喘患者(162名)的随访研究,总共历时25年,调查哮喘患者病程的治疗结果,探究首个治疗年的一秒用力呼气容积(FEV1)是否可以预测长期预后。
方法:133名患者(83%)完整地参加了25年的调查。 在这次随访研究中,评估了包括肺功能在内的基本哮喘检查指标以及健康相关生活质量问卷(HRQOL),GINA和哮喘控制测试。 本研究哮喘药物的使用方法,包括药物的减少与停用,已经得到证实可行。
结果:从实验开始到控制25年后,预测的平均FEV1%没有统计学上的显著变化。第一年FEV1%的变化可以预测随访结束时的结果。如果第一年末的哮喘患者FEV1%是正常的,则可以预测25年后该患者FEV1%也正常;如果第一年末FEV1%偏低,则25年后FEV1%也偏低。本研究中有29名患者(26.4%)在随访期间停止了药物治疗,有6名患者(5.5%)定期使用吸入糖皮质激素(ICS)。随访结果显示16.4%的哮喘患者达到了临床缓解,7.6%达到了功能性缓解。通过健康相关生活质量问卷发现,哮喘患者在随访期间总体生活质量保持不变。
结论:在成人哮喘发作期,首个治疗年度达到的FEV1水平似乎可以预测将来的肺功能水平。本次随访中四分之一的哮喘患者停止了哮喘治疗,但他们的HRQOL比那些继续使用ICS的患者要好。哮喘患者的临床缓解率为16%,与其他研究结果一致。
延伸阅读
Allergy
[IF:6.048]
The first year of treatment predicts the prognosis of asthma over 25 y—A prospective study
DOI: 10.1111/all.13983
Abstract:
Background: An investigator‐driven, real‐life follow‐up study of adult‐onset steroid‐naïve, newly diagnosed asthma (162 patients) to investigate the treatment results over the 25‐year course of the disease and whether the first treatment year's forced expiratory volume in one second (FEV1) predicts the long‐term prognosis.
Methods: Eighty‐three per cent of the 133 living patients participated in the 25‐year examinations. At this visit, basic asthma examinations including lung function, as well as questionnaires for health‐related quality of life (HRQoL), GINA and the Asthma Control Test, were used for evaluation. The use of medication and remission was verified.
Results: There was no statistically significant change in mean FEV1% predicted (FEV1%) from baseline to the 25‐year control. The changes in FEV1% during the first year predicted the results at the end of follow‐up. Normal FEV1% at the end of the first year predicted normal FEV1, and below‐normal FEV1% at 1 year predicted below‐normal FEV 1% at 25 years. Twenty‐nine patients (26.4%) had discontinued their medication, and six (5.5%) used ICS periodically. Clinical remission was reached by 16.4% of the patients, and 7.6% reached functional remission. The general HRQoL remained unchanged.
Conclusion: In adult‐onset asthma, the level of FEV1 reached during the first treatment year seems to predict the later lung function level. One quarter of the patients discontinued the asthma treatment, but their HRQoL was better than that of those continuing to use ICS. Clinical remission was reached by 16% of the patients, which is in concordance with other studies.
First Author:
Ritva Kauppinen
Correspondence:
Jouni Hedman, Department of Pulmonary Diseases, Valto Käkelänkatu 1, 53130 Lappeenranta, Finland
All Authors:
Ritva Kauppinen, Vesa Vilkka, Harri Sintonen, Jouni Hedman
2020-01-18 Article
创建过敏性疾病的科研、科普知识交流平台,为过敏患者提供专业诊断、治疗、预防的共享平台。