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ATSIC 2016:10年的标准治疗也不能缓解持续性难治性哮喘症状?

2016-05-18 Seven L 译 MedSci原创

美国胸腔医学会国际会议年会称,TENOR II队列中近一半的重度或难治性哮喘患者,在超过10年的治疗后,其哮喘症状仍很难控制。加利福尼亚洛斯阿尔托斯EpiMetrix的Tmirah Haselkorn博士和同事还报道了与持续难控制哮喘相关的临床和人口统计学因素。TENOR II试验是一项多中心、观察性研究,继TENOR I试验后对难控制哮喘患者的随访和评估超过10年。该试验包含了341名患者,有3

美国胸腔医学会国际会议年会称,TENOR II队列中近一半的重度或难治性哮喘患者,在超过10年的治疗后,其哮喘症状仍很难控制。

加利福尼亚洛斯阿尔托斯EpiMetrix的Tmirah Haselkorn博士和同事还报道了与持续难控制哮喘相关的临床和人口统计学因素。

TENOR II试验是一项多中心、观察性研究,继TENOR I试验后对难控制哮喘患者的随访和评估超过10年。该试验包含了341名患者,有327名患者在两个时间点有一个可用的哮喘控制水平。

研究者根据国家心脏、肺和血液研究所的哮喘指南对患者进行分类。将TENOR I、II试验中均有难控制哮喘症状的患者定义为持续性难治性哮喘,对照组则是余下其他患者。

数据显示,持续性难治性哮喘患者占48%,与对照组相比,患者有较高的并发症,包括胃食管反流病(52.2% vs. 41.2%);另外肺功能更差,并且在过去12个月里,病情恶化需要住院或急诊行糖皮质激素治疗的风险更高(29.7% vs. 9%)。不仅如此,两组的差异还体现在更低的预扩张FEV1预测百分比(62.5% vs. 82.1%)和支气管扩张剂后FEV1占预计值百分比(69.1% vs. 86.5%),更高的总IgE抗体几何平均值(89.3 vs. 55.7)。

研究者还发现,持续性哮喘控制极差的患者更可能是黑人,当前吸烟或既往有吸烟史,前3个月的哮喘恶化使用支气管扩张剂后FEV1占预计值百分比下降。

研究人员在他们的摘要中总结说:“尽管有标准的治疗,但持续性难控制的哮喘患者的症状在治疗10年后仍很普遍。相比对照组,这些患者表现出更高的疾病负担,肺功能损伤更重,总IgE和特异性IgE水平也更高。可以对与之相关的人口和临床预测因素进行直接强化管理。”

原始出处:

Haselkorn T, et al. Prevalence and risk factors for persistent very poorly controlled asthma after more than a decade in the TENOR II cohort. Presented at: American Thoracic Society International Conference, May 13-18, 2016; San Francisco.

Very poorly controlled asthma may persist for more than a decade despite treatment
.Healio.May 17, 2016

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    2016-09-18 1e10c84am36(暂无匿称)

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    2016-05-20 freve

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