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女性健康研究中随机分配服用阿司匹林与成人期哮喘风险

Randomised aspirin assignment and risk of adult-onset asthma in the Women's Health Study.

作者信息

Kurth T, Barr R G, Gaziano J M, Buring J E

机构信息

Division of Preventive Medicine, Brigham and Women's Hospital, 900 Commonwealth Ave East, 3rd Floor, Boston, MA 02215, USA.

出版信息

Thorax. 2008 Jun;63(6):514-8. doi: 10.1136/thx.2007.091447. Epub 2008 Mar 13.

Abstract

BACKGROUND

Randomised data in men show a small but significant reduction in the risk of adult-onset asthma among those given aspirin. The results from an observational study in women suggest that frequent use of aspirin decreases the risk of adult-onset asthma, but randomised data in women are lacking. A study was undertaken to test the effect of 100 mg aspirin or placebo on alternate days on the risk of adult-onset asthma in the Women's Health Study.

METHODS

A randomised, double-blind, placebo-controlled clinical trial of aspirin and vitamin E was performed in apparently healthy women with no indication or contraindication to aspirin therapy and no history of asthma at study entry. Female health professionals self-reported an asthma diagnosis on yearly questionnaires.

RESULTS

Among 37 270 women with no reported history of asthma prior to randomisation and during 10 years of follow-up, there were 872 new cases diagnosed with asthma in the aspirin group and 963 in the placebo group (hazard ratio 0.90; 95% CI 0.82 to 0.99; p = 0.027). This apparent 10% lower relative risk of incident adult-onset asthma among those assigned to aspirin was significantly modified by body mass index, with no effect in women with a body mass index of >/=30 kg/m2. The effect of aspirin on adult-onset asthma was not significantly modified by age, smoking status, exercise levels, postmenopausal hormone use or randomised vitamin E assignment.

CONCLUSIONS

In this large randomised clinical trial of apparently healthy adult women, administration of 100 mg aspirin on alternate days reduced the relative risk of a newly reported diagnosis of asthma.

摘要

背景

男性的随机数据显示,服用阿司匹林的人群中成人哮喘发病风险有小幅但显著的降低。一项针对女性的观察性研究结果表明,频繁使用阿司匹林可降低成人哮喘发病风险,但缺乏女性的随机数据。开展了一项研究,以测试在女性健康研究中隔天服用100毫克阿司匹林或安慰剂对成人哮喘发病风险的影响。

方法

在无阿司匹林治疗指征或禁忌且入组时无哮喘病史的明显健康女性中进行了一项阿司匹林和维生素E的随机、双盲、安慰剂对照临床试验。女性健康专业人员通过年度问卷自我报告哮喘诊断情况。

结果

在随机分组前及10年随访期间无哮喘病史报告的37270名女性中,阿司匹林组有872例新诊断哮喘病例,安慰剂组有963例(风险比0.90;95%置信区间0.82至0.99;p = 0.027)。体重指数对分配到阿司匹林组的人群中成人哮喘发病相对风险明显降低10%有显著影响,体重指数≥30 kg/m2的女性无此效果。年龄、吸烟状况、运动水平、绝经后激素使用情况或随机分配的维生素E对阿司匹林对成人哮喘发病的影响无显著影响。

结论

在这项针对明显健康成年女性的大型随机临床试验中,隔天服用100毫克阿司匹林降低了新报告哮喘诊断的相对风险。

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