CK-CARE, Christine Kühne Center for Allergy Research and Education, Davos, Switzerland.
Department of Dermatology, Allergy Unit, Zurich University Hospital, Zurich, Switzerland.
Pediatr Allergy Immunol. 2017 Dec;28(8):768-775. doi: 10.1111/pai.12808. Epub 2017 Nov 2.
Rehabilitational programs at moderate altitude (1500-2500 m) showed improvement of lung function and reduction in airways inflammation in asthmatic adults. Allergen avoidance was postulated as the major cause of these improvements.
Spirometries of 344 and fractional exhaled nitric oxide measurements (FeNO) of 124 asthmatic children and adolescents, staying in a rehabilitation hospital in Davos (1590 m) with at least 14 days between admission and discharge, were analyzed in association with atopic sensitization (skin-prick testing and/or specific IgE), level of asthma control, and inhalative corticosteroid (ICS) dose.
Pulmonary conditions improved significantly on average during the sojourn. Uncontrolled asthmatics benefited most with an absolute increase in predicted FEV , MEF , and MEF of 7.7%, 9.9%, and 12.7%, respectively (P < .001). FeNO decreased by 36.9 ppb for uncontrolled, by 26.9 ppb for partly controlled, and by 11.8 ppb for controlled asthmatics. In uncontrolled subjects, pulmonary improvement was comparable between patients with and without house dust mites (HDM) sensitization. Pulmonary improvements of pollen-sensitized patients were not dependent on the season of the sojourn. For the group with constant ICS level, the absolute increase in FEV was 4.9% (P < .001) with a FeNO decreased by 32.7 ppb (P < .001). When the ICS dose was elevated by one GINA level, the absolute increase in FEV was slightly higher (6.6%, P < .001), with a FeNO decrease of 31.4 ppb (P < .001).
Inpatient rehabilitation at moderate altitude improved pulmonary conditions in asthmatic children and adolescents independent of sensitization status to HDM or pollen. A positive effect was also observed in patients without change in medication.
在中海拔（1500-2500 米）进行康复计划可改善成年哮喘患者的肺功能并减轻气道炎症。过敏原回避被认为是这些改善的主要原因。
分析了 344 名哮喘儿童和青少年的肺活量测定值和 124 名哮喘儿童和青少年的呼出气一氧化氮分数测量值（FeNO），这些患者在达沃斯（海拔 1590 米）的康复医院住院至少 14 天，入院和出院之间，并与特应性致敏（皮肤点刺试验和/或特异性 IgE）、哮喘控制水平和吸入性皮质类固醇（ICS）剂量相关联。
在逗留期间，肺部状况平均显著改善。未控制的哮喘患者受益最大，FEV ，MEF 和 MEF 的预测值分别增加了 7.7%、9.9%和 12.7%（P<.001）。未控制的哮喘患者 FeNO 降低了 36.9 ppb，部分控制的哮喘患者降低了 26.9 ppb，控制的哮喘患者降低了 11.8 ppb。在未控制的患者中，尘螨（HDM）致敏与无 HDM 致敏的患者之间的肺部改善情况相当。花粉致敏患者的肺部改善与逗留季节无关。对于 ICS 水平恒定的患者，FEV 的绝对增加为 4.9%（P<.001），FeNO 降低了 32.7 ppb（P<.001）。当 ICS 剂量提高一个 GINA 水平时，FEV 的绝对增加稍高（6.6%，P<.001），FeNO 降低了 31.4 ppb（P<.001）。
在中海拔进行住院康复可改善哮喘儿童和青少年的肺部状况，而与 HDM 或花粉致敏状态无关。在没有改变药物治疗的情况下，也观察到了积极的效果。
