Ospedale Policlinico San Martino, Genoa, Italy.
Health Science Department, University of Genoa, Genoa, Italy.
Respir Med. 2018 Mar;136:58-64. doi: 10.1016/j.rmed.2018.01.018. Epub 2018 Jan 31.
Asthma is characterized by airway inflammation and bronchial hyperreactivity. It is conceived that aging may affect asthma characteristics, but this issue is still not completely clarified in clinical practice.
The present study investigated whether aging may affect some clinical and functional factors in outpatients with asthma visited in a real-world setting, such as clinical practice.
Globally, 391 outpatients (163 males, median age 47 years) with asthma were consecutively evaluated. The following parameters were assessed: history, including, smoking, comorbidity, and inhaled corticosteroids (ICS) use, physical examination, body mass index (BMI), lung function, level of asthma control, asthma control test (ACT), and fractional exhaled NO (FeNO).
The elderly with asthma had: more frequently not controlled asthma, higher BMI, higher ICS dosages, more impaired lung function, including plethysmographic parameters, than adult asthmatics (p < 0.001 for all, but p = 0.002 for RV and p = 0.008 for FRC). Elderly asthmatics were also less frequently allergic (p < 0.001) and had less rhinitis comorbidity (p < 0.001) and less nasal symptoms (p < 0.05) than younger asthmatics.
The present study conducted in a real-world setting shows that aging significantly affects asthma, mainly concerning asthma control, lung function, and steroid-sensitivity.
哮喘的特征为气道炎症和支气管高反应性。据推测，衰老可能会影响哮喘的特征，但这一问题在临床实践中仍未得到完全阐明。
本研究旨在探讨衰老是否会影响在真实环境中就诊的哮喘患者的某些临床和功能因素，例如临床实践。
本研究共纳入 391 名哮喘门诊患者（163 名男性，中位年龄 47 岁），对其进行了连续评估。评估的参数包括：病史，包括吸烟、合并症和吸入性皮质类固醇（ICS）的使用情况；体格检查；体重指数（BMI）；肺功能；哮喘控制水平；哮喘控制测试（ACT）；以及呼出气一氧化氮（FeNO）分数。
与成年哮喘患者相比，老年哮喘患者：哮喘控制不佳的比例更高，BMI 更高，ICS 剂量更高，肺功能受损更严重，包括体描法参数（所有参数 p 值均＜0.001，但 RV 的 p 值=0.002，FRC 的 p 值=0.008）。老年哮喘患者也较少为过敏体质（p 值＜0.001），合并变应性鼻炎的比例较低（p 值＜0.001），鼻部症状较少（p 值＜0.05）。
本研究在真实环境中进行，结果表明衰老显著影响哮喘，主要涉及哮喘控制、肺功能和类固醇敏感性。
