肥胖哮喘患者体重减轻的即时和长期影响：随机对照研究
Immediate and long term effects of weight reduction in obese people with asthma: randomised controlled study.
作者信息
Stenius-Aarniala B, Poussa T, Kvarnström J, Grönlund E L, Ylikahri M, Mustajoki P
机构信息
Division of Pulmonary Medicine and Allergology, Helsinki University Central Hospital, FIN-00029 HYKS, Helsinki, Finland.
出版信息
BMJ. 2000 Mar 25;320(7238):827-32. doi: 10.1136/bmj.320.7238.827.
OBJECTIVE
To investigate the influence of weight reduction on obese patients with asthma.
DESIGN
Open study, two randomised parallel groups.
SETTING
Private outpatients centre, Helsinki, Finland.
PARTICIPANTS
Two groups of 19 obese patients with asthma (body mass index (kg/m(2)) 30 to 42) recruited through newspaper advertisements.
INTERVENTION
Supervised weight reduction programme including 8 week very low energy diet.
MAIN OUTCOME MEASURES
Body weight, morning peak expiratory flow (PEF), forced vital capacity (FVC), forced expiratory volume in one second (FEV(1)); and also asthma symptoms, number of acute episodes, courses of oral steroids, health status (quality of life).
RESULTS
At the end of the weight reducing programme, the participants in the treatment group had lost a mean of 14.5% of their pretreatment weight, the controls 0.3%. The corresponding figures after one year were 11.3% and a weight gain of 2.2%. After the 8 week dieting period the difference in changes in percentage of predicted FEV(1) from baseline in the treatment and control groups was 7.2% (95% confidence interval 1.9% to 12.5%, P=0. 009). The corresponding difference in the changes in FVC was 8.6% (4. 8% to 12.5%, P<0.0001). After one year the differences in the changes in the two groups were still significant: 7.6% for FEV(1) (1. 5% to 13.8%, P=0.02) and 7.6% for FVC (3.5% to 11.8%, P=0.001). By the end of the weight reduction programme, reduction in dyspnoea was 13 mm (on a visual analogue scale 0 mm to 100 mm) in the treatment group and 1 mm in the control group (P=0.02). The reduction of rescue medication was 1.2 and 0.1 doses respectively (P=0.03). After one year the differences in the changes between the two groups were -12 for symptom scores (range -1 to -22, P=0.04) and -10 for total scores (-18 to -1, P=0.02). The median number of exacerbations in the treatment group was 1 (0-4) and in the controls 4 (0-7), P=0.001.
CONCLUSION
Weight reduction in obese patients with asthma improves lung function, symptoms, morbidity, and health status.
目的
研究体重减轻对肥胖哮喘患者的影响。
设计
开放性研究，两个随机平行组。
地点
芬兰赫尔辛基的私立门诊中心。
参与者
通过报纸广告招募的两组19名肥胖哮喘患者（体重指数（kg/m²）为30至42）。
干预措施
监督性体重减轻计划，包括为期8周的极低能量饮食。
主要观察指标
体重、晨峰呼气流量（PEF）、用力肺活量（FVC）、一秒用力呼气容积（FEV₁）；以及哮喘症状、急性发作次数、口服类固醇疗程、健康状况（生活质量）。
结果
在体重减轻计划结束时，治疗组参与者的体重较治疗前平均减轻了14.5%，对照组减轻了0.3%。一年后的相应数据分别为11.3%和体重增加2.2%。在为期8周的节食期后，治疗组和对照组预测FEV₁较基线的变化百分比差异为7.2%（95%置信区间1.9%至12.5%，P = 0.009）。FVC变化的相应差异为8.6%（4.8%至12.5%，P < 0.0001）。一年后，两组变化的差异仍然显著：FEV₁为7.6%（1.5%至13.8%，P = 0.02），FVC为7.6%（3.5%至11.8%，P = 0.001）。在体重减轻计划结束时，治疗组呼吸困难程度降低了13mm（视觉模拟评分0mm至100mm），对照组降低了1mm（P = 0.02）。急救药物的减少量分别为1.2剂和0.1剂（P = 0.03）。一年后，两组变化的差异在症状评分方面为-12（范围-1至-22，P = 0.04），总分方面为-
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