Bochenek Grazyna, Szafraniec Krystyna, Kuschill-Dziurda Joanna, Nizankowska-Mogilnicka Ewa
Department of Internal Medicine, Jagiellonian University Medical College, Skawinska 8, 31-066 Krakow, Poland.
Department of Epidemiology and Population Studies, Faculty of Health Sciences, Jagiellonian University Medical College, Grzegorzecka 20, 31-531 Krakow, Poland.
Respir Med. 2015 May;109(5):588-95. doi: 10.1016/j.rmed.2015.02.015. Epub 2015 Mar 10.
Effective control of asthma is the primary goal of its treatment. Despite an improved understanding of asthma pathogenesis and accessibility of novel therapies, the rate of uncontrolled asthma remains high.
To find potential factors associated with asthma control in patients with aspirin-exacerbated respiratory disease (AERD).
Clinical data were collected from a specifically structured questionnaire. Demographics, a history of upper airway symptoms, asthma course, exacerbations expressed as emergency department (ED) visits/hospitalizations, and asthma treatment were considered. Spirometry, skin prick tests, total IgE concentration, and blood eosinophil count were evaluated. Asthma control was assessed through the Asthma Control Test (ACT).
Out of 201 AERD patients, 41 (20.4%), 69 (34.3%), and 91 (45.3%) had controlled, partially controlled, and uncontrolled asthma, respectively. A multivariate ordered logistic regression analysis revealed that hospitalizations for asthma in the previous 12 months (OR 2.88; 95%CI, 1.11-7.46), ED visits for asthma throughout its duration (OR 1.05; 95%CI, 1.004-1.10), and total IgE concentration (OR 1.28; 95%CI, 1.02-1.60) were positively associated with poor asthma control, whereas FEV1 values (OR 0.98; 95%CI, 0.96-0.99) and medical care at a referential specialty clinic (OR 0.50; 95%CI, 0.27-0.95) were positively associated with good asthma control.
The prevalence of uncontrolled asthma in AERD patients is high and similar to that observed in different asthmatic populations. Owing both to the specificity and complexity of the disease, AERD patients should stay under regular care of well experienced referential medical centers to ensure that this asthma phenotype is dealt with effectively.
有效控制哮喘是其治疗的首要目标。尽管对哮喘发病机制的认识有所提高，且新型疗法也更容易获得，但哮喘控制不佳的比例仍然很高。
寻找阿司匹林诱发的呼吸道疾病（AERD）患者中与哮喘控制相关的潜在因素。
通过一份专门设计的问卷收集临床数据。考虑了人口统计学、上呼吸道症状史、哮喘病程、以急诊就诊/住院次数表示的病情加重情况以及哮喘治疗情况。评估了肺功能、皮肤点刺试验、总IgE浓度和血液嗜酸性粒细胞计数。通过哮喘控制测试（ACT）评估哮喘控制情况。
在201例AERD患者中，分别有41例（20.4%）、69例（34.3%）和91例（45.3%）的哮喘得到控制、部分控制和未得到控制。多变量有序逻辑回归分析显示，过去12个月因哮喘住院（比值比2.88；95%置信区间，1.11 - 7.46）、哮喘病程中急诊就诊次数（比值比1.05；95%置信区间，1.004 - 1.10）和总IgE浓度（比值比1.28；95%置信区间，1.02 - 1.60）与哮喘控制不佳呈正相关，而第1秒用力呼气容积（FEV1）值（比值比0.98；95%置信区间，0.96 - 0.99）和在参考专科诊所接受的医疗护理（比值比0.50；95%置信区间，0.27 - 0.95）与哮喘良好控制呈正相关。
AERD患者中哮喘控制不佳的患病率很高，与在不同哮喘人群中观察到的情况相似。由于该疾病的特殊性和复杂性，AERD患者应在经验丰富的参考医疗中心接受定期护理，以确保有效应对这种哮喘表型。
