The National Institute for Health Research Respiratory Biomedical Research Unit, Royal Brompton, Harefield NHS Foundation Trust, and Imperial College, London, UK; Chelsea and Westminster Hospital, London, UK.
The National Institute for Health Research Respiratory Biomedical Research Unit, Royal Brompton, Harefield NHS Foundation Trust, and Imperial College, London, UK; Chelsea and Westminster Hospital, London, UK.
Lancet Respir Med. 2013 May;1(3):233-40. doi: 10.1016/S2213-2600(13)70047-X. Epub 2013 Apr 23.
Few treatment options exist for patients with severe emphysema. We assessed the clinical benefits and safety of lung volume reduction coils (LVRCs) for the treatment of patients with severe emphysema with hyperinflation.
In a randomised study, we recruited patients with severe emphysema (aged ≥35 years) from three centres in the UK. Using a computer-generated randomisation sequence, we randomly allocated patients in a one-to-one ratio (block sizes of four and stratified by centre) to either LVRC treatment (treatment group) or best medical care (usual care group). The primary endpoint was the difference in response in the St George's Respiratory Questionnaire (SGRQ) between treatment and usual care groups at 90 days after final treatment (by intention-to-treat analysis). The trial is registered with ClinicalTrials.gov, number NCT01334307.
Between Jan 27, 2010, to Oct 25, 2011, we recruited and randomly allocated 47 patients: 23 to treatment and 24 to usual care (23 patients in each group were included in the intention-to-treat analysis). SGRQ response at 90 days after final treatment was greater in the treatment group than it was in the usual care group (between-group difference in change from baseline -8·36 points [95% CI -16·24 to -0·47]; p=0·04). We detected no between-group difference in serious adverse events.
Our findings suggest that treatment with endobronchial coils can improve quality of life for patients with severe emphysema and hyperinflation.
PneumRx.
患有严重肺气肿的患者可选择的治疗方法很少。我们评估了肺减容线圈（LVRC）治疗伴有过度充气的严重肺气肿患者的临床获益和安全性。
在一项随机研究中，我们从英国的三个中心招募了患有严重肺气肿（年龄≥35 岁）的患者。使用计算机生成的随机序列，我们按照 1:1 的比例（分组大小为 4 个，按中心分层）将患者随机分配到 LVRC 治疗（治疗组）或最佳药物治疗（常规治疗组）。主要终点是治疗后 90 天，治疗组和常规治疗组在圣乔治呼吸问卷（SGRQ）中的反应差异（意向治疗分析）。该试验在 ClinicalTrials.gov 上注册，编号为 NCT01334307。
2010 年 1 月 27 日至 2011 年 10 月 25 日，我们招募并随机分配了 47 名患者：23 名接受治疗，24 名接受常规治疗（每组各有 23 名患者纳入意向治疗分析）。治疗后 90 天，SGRQ 反应在治疗组大于常规治疗组（治疗组与常规治疗组之间的基线变化差异为-8.36 分[95%CI-16.24 至-0.47]；p=0.04）。我们未发现两组间严重不良事件存在差异。
我们的发现表明，支气管内线圈治疗可改善伴有过度充气的严重肺气肿患者的生活质量。
PneumRx。
