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慢性气道疾病中长期湿化治疗的临床实用性。

The clinical utility of long-term humidification therapy in chronic airway disease.

机构信息

University of Auckland, Auckland, New Zealand.

出版信息

Respir Med. 2010 Apr;104(4):525-33. doi: 10.1016/j.rmed.2009.12.016. Epub 2010 Feb 9.

Abstract

AIM

Persistent airway inflammation with mucus retention in patients with chronic airway disorders such as COPD and bronchiectasis may lead to frequent exacerbations, reduced lung function and poor quality of life. This study investigates if long-term humidification therapy with high flow fully humidified air at 37 degrees C through nasal cannulae can improve these clinical outcomes in this group of patients.

METHOD

108 patients diagnosed with COPD or bronchiectasis were randomised to daily humidification therapy or usual care for 12 months over which exacerbations were recorded. Lung function, quality of life, exercise capacity, and measures of airway inflammation were also recorded at baseline, 3 and 12 months.

RESULTS

Patients on long-term humidification therapy had significantly fewer exacerbation days (18.2 versus 33.5 days; p = 0.045), increased time to first exacerbation (median 52 versus 27 days; p = 0.0495) and reduced exacerbation frequency (2.97/patient/year versus 3.63/patient/year; p = 0.067) compared with usual care. Quality of life scores and lung function improved significantly with humidification therapy compared with usual care at 3 and 12 months.

CONCLUSION

Long-term humidification therapy significantly reduced exacerbation days, increased time to first exacerbation, improved lung function and quality of life in patients with COPD and bronchiectasis. Clinical trial registered with www.actr.org.au; Number ACTRN2605000623695.

摘要

目的

患有慢性气道疾病(如 COPD 和支气管扩张症)的患者气道内持续存在炎症和黏液潴留,可能导致频繁恶化、肺功能下降和生活质量降低。本研究旨在探讨通过鼻塞给予 37°C 高流量完全湿化空气进行长期湿化治疗是否能改善此类患者的这些临床结局。

方法

将 108 例诊断为 COPD 或支气管扩张症的患者随机分为每日湿化治疗组或常规护理组,治疗时间为 12 个月,在此期间记录恶化情况。在基线、3 个月和 12 个月时,还记录了肺功能、生活质量、运动能力和气道炎症指标。

结果

长期湿化治疗组的恶化天数明显减少(18.2 天比 33.5 天;p = 0.045),首次恶化时间延长(中位数 52 天比 27 天;p = 0.0495),恶化频率降低(2.97/患者/年比 3.63/患者/年;p = 0.067)。与常规护理相比,湿化治疗组的生活质量评分和肺功能在 3 个月和 12 个月时均显著改善。

结论

长期湿化治疗可显著减少 COPD 和支气管扩张症患者的恶化天数,延长首次恶化时间,改善肺功能和生活质量。临床研究注册于 www.actr.org.au;注册号 ACTRN2605000623695。

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