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成人哮喘的12年预后:塞伊奈约基成人哮喘研究。

A 12-year prognosis of adult-onset asthma: Seinäjoki Adult Asthma Study.

作者信息

Tuomisto Leena E, Ilmarinen Pinja, Niemelä Onni, Haanpää Jussi, Kankaanranta Terhi, Kankaanranta Hannu

机构信息

Department of Respiratory Medicine, Seinäjoki Central Hospital, Seinäjoki, Finland.

Department of Respiratory Medicine, Seinäjoki Central Hospital, Seinäjoki, Finland.

出版信息

Respir Med. 2016 Aug;117:223-9. doi: 10.1016/j.rmed.2016.06.017. Epub 2016 Jun 23.

Abstract

RATIONALE

Long-term prognosis of adult-onset asthma is poorly known.

OBJECTIVE

To evaluate 12-year prognosis of adult-onset asthma and the factors associated with disease prognosis.

METHODS

Seinäjoki Adult-onset Asthma Study (SAAS) is a 12-year real-life single-center follow-up study of new-onset asthma diagnosed at adult age and treated in primary and specialized care. Remission was defined by no symptoms and no asthma medication use for 6 months. Asthma control was evaluated according to Global Initiative for Asthma 2010. Factors associated with current asthma control were analyzed by multinomial multivariate logistic regression.

MAIN RESULTS

A total of 203 patients (79% of the baseline population) were followed for 12 years. Remission occurred in 6 (3%) patients. In 34% asthma was controlled, in 36% it was partially controlled and in 30% uncontrolled. Uncontrolled asthma was predicted by elevated body-mass index at baseline, smoking (pack-years) and current allergic or persistent rhinitis. Elevated blood eosinophils and good lung function (FEV1) at baseline protected from uncontrolled asthma. In contrast, gender, age at the onset or baseline symptoms (Airways Questionnaire 20) were not significant predictors of uncontrolled disease.

CONCLUSIONS

During a 12-year follow-up, remission of adult-onset asthma was rare occurring in only 3% of patients. The majority of patients (66%) presented either with uncontrolled or partially controlled asthma. This study is registered at ClinicalTrials.gov with identifier number NCT02733016.

摘要

理论依据

成人哮喘的长期预后鲜为人知。

目的

评估成人哮喘的12年预后以及与疾病预后相关的因素。

方法

塞纳约基成人哮喘研究(SAAS)是一项为期12年的单中心实际随访研究,研究对象为成年期新诊断的哮喘患者,这些患者在初级和专科护理机构接受治疗。缓解的定义为6个月内无哮喘症状且未使用哮喘药物。根据全球哮喘防治创议(GINA)2010版评估哮喘控制情况。通过多项多变量逻辑回归分析与当前哮喘控制相关的因素。

主要结果

共对203例患者(占基线人群的79%)进行了12年的随访。6例(3%)患者实现缓解。34%的患者哮喘得到控制,36%为部分控制,30%为未控制。基线时体重指数升高、吸烟(包年数)以及当前存在变应性或持续性鼻炎可预测哮喘未得到控制。基线时血嗜酸性粒细胞升高和肺功能良好(FEV1)可预防哮喘未得到控制。相比之下,性别、发病年龄或基线症状(气道问卷20)并非哮喘未得到控制的显著预测因素。

结论

在12年的随访期间,成人哮喘缓解情况罕见,仅3%的患者实现缓解。大多数患者(66%)的哮喘未得到控制或为部分控制。本研究已在ClinicalTrials.gov注册,标识符为NCT02733016。

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