吸入性糖皮质激素与社区哮喘居民的肺功能下降
Inhaled corticosteroids and decline of lung function in community residents with asthma.
作者信息
Lange P, Scharling H, Ulrik C S, Vestbo J
机构信息
Department of Cardiology and Respiratory Diseases, Hvidovre University Hospital, DK-2650 Hvidovre, Denmark.
出版信息
Thorax. 2006 Feb;61(2):100-4. doi: 10.1136/thx.2004.037978.
BACKGROUND
Inhaled corticosteroids (ICS) constitute the cornerstone of treatment for asthma. Many studies have reported beneficial short term effects of these drugs, but there are few data on the long term effects of ICS on the decline in forced expiratory volume in 1 second (FEV(1)). This study was undertaken to determine whether adults with asthma treated with ICS have a less pronounced decline in FEV(1) than those not treated with ICS.
METHODS
Two hundred and thirty four asthmatic individuals from a longitudinal epidemiological study of the general population of Copenhagen, Denmark were divided into two groups; 44 were treated with ICS and 190 were not treated with ICS. The annual decline in FEV(1) was measured over a 10 year follow up period.
RESULTS
The decline in FEV(1) in the 44 patients receiving ICS was 25 ml/year compared with 51 ml/year in the 190 patients not receiving this treatment (p<0.001). The linear regression model with ICS as the variable of interest and sex, smoking, and wheezing as covariates showed that treatment with ICS was associated with a less steep decline in FEV(1) of 18 ml/year (p = 0.01). Adjustment for additional variables including age, socioeconomic status, body mass index, mucus hypersecretion, and use of other asthma medications did not change these results.
CONCLUSIONS
Treatment with ICS is associated with a significantly reduced decline in ventilatory function.
背景
吸入性糖皮质激素（ICS）是哮喘治疗的基石。许多研究报道了这些药物的短期有益效果，但关于ICS对1秒用力呼气容积（FEV₁）下降的长期影响的数据较少。本研究旨在确定接受ICS治疗的成年哮喘患者FEV₁的下降是否比未接受ICS治疗的患者更不明显。
方法
来自丹麦哥本哈根普通人群纵向流行病学研究的234名哮喘患者被分为两组；44名接受ICS治疗，190名未接受ICS治疗。在10年的随访期内测量FEV₁的年下降情况。
结果
44名接受ICS治疗的患者FEV₁的下降为每年25毫升，而190名未接受该治疗的患者为每年51毫升（p<0.001）。以ICS为感兴趣变量，性别、吸烟和喘息为协变量的线性回归模型显示，ICS治疗与FEV₁每年较缓的18毫升下降相关（p = 0.01）。对包括年龄、社会经济地位、体重指数、黏液高分泌和使用其他哮喘药物在内的其他变量进行调整后，这些结果没有改变。
结论
ICS治疗与通气功能下降显著减少相关。
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