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嗜酸性粒细胞性支气管炎患者慢性气道阻塞的发展:一项前瞻性随访研究。

Development of chronic airway obstruction in patients with eosinophilic bronchitis: a prospective follow-up study.

作者信息

Park Sung-Woo, Lee Young Mok, Jang An Soo, Lee June Hyuk, Hwangbo Young, Kim Do Jin, Park Choon-Sik

机构信息

Asthma and Allergy Research Group, Soonchunhyang University Hospital, Bucheon, Korea.

出版信息

Chest. 2004 Jun;125(6):1998-2004. doi: 10.1378/chest.125.6.1998.

Abstract

STUDY OBJECTIVES

Eosinophilic bronchitis (EB) presents as a chronic cough and sputum eosinophilia without airflow limitation or bronchial hyperreactivity. Its long-term clinical course remains unknown. This study evaluated how frequently EB recurs and whether it develops chronic airway obstruction.

DESIGN

This study was a prospective analysis.

METHODS

Cough severity, FEV(1), provocative concentration of methacholine causing a 20% fall in FEV(1), and sputum eosinophil percentages were serially measured in 36 subjects for up to 48 months. All subjects inhaled corticosteroids until cough subsided.

RESULTS

Five of the twenty four follow-up subjects (21%) had a recurrent episode of EB 4 to 6 months after disappearance of the first episode of EB (recurrent eosinophilic bronchitis). Progressive FEV(1) reduction > 20% was observed in three of the subjects, including a subject with asthma developing at the ninth month. Nineteen subjects had no recurrence of cough (nonrecurrent eosinophilic bronchitis) and no progressive FEV(1) reduction > 20%. However, sputum eosinophilia recurred between 4 months and 24 months in 10 subjects. Mean values of FEV(1) at the ninth and 12th months of the study were significantly lower in the recurrent eosinophilic bronchitis group than in the nonrecurrent eosinophilic bronchitis group (p < 0.01).

CONCLUSION

These results suggest that repeated episode of EB is associated with the development of chronic airflow obstruction, including asthma.

摘要

研究目的

嗜酸性粒细胞性支气管炎(EB)表现为慢性咳嗽和痰液嗜酸性粒细胞增多,无气流受限或支气管高反应性。其长期临床病程尚不清楚。本研究评估了EB复发的频率以及是否会发展为慢性气道阻塞。

设计

本研究为前瞻性分析。

方法

对36名受试者连续测量长达48个月的咳嗽严重程度、第一秒用力呼气容积(FEV₁)、使FEV₁下降20%的乙酰甲胆碱激发浓度以及痰液嗜酸性粒细胞百分比。所有受试者吸入糖皮质激素直至咳嗽缓解。

结果

24名随访受试者中有5名(21%)在首次EB发作消失后4至6个月出现EB复发(复发性嗜酸性粒细胞性支气管炎)。3名受试者观察到FEV₁进行性下降>20%,其中1名受试者在第9个月发生哮喘。19名受试者未出现咳嗽复发(非复发性嗜酸性粒细胞性支气管炎)且FEV₁无进行性下降>20%。然而,10名受试者在4个月至24个月期间痰液嗜酸性粒细胞增多复发。复发性嗜酸性粒细胞性支气管炎组在研究第9个月和第12个月时的FEV₁平均值显著低于非复发性嗜酸性粒细胞性支气管炎组(p<0.01)。

结论

这些结果表明,EB反复发作与包括哮喘在内的慢性气流阻塞的发生有关。

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