LAM 可逆性气道阻塞的横断面研究：需要更好的证据来支持支气管扩张剂和吸入性类固醇的使用。

Cross-sectional study of reversible airway obstruction in LAM: better evidence is needed for bronchodilator and inhaled steroid use.

机构信息

Division of Respiratory Medicine and NIHR Biomedical Research Centre and National Centre for LAM, Nottingham Unioversity NHS Trust, Nottingham UK, University of Nottingham, Nottingham, UK.

Division of Respiratory Medicine and NIHR Biomedical Research Centre and National Centre for LAM, Nottingham Unioversity NHS Trust, Nottingham UK, University of Nottingham, Nottingham, UK

出版信息

Thorax. 2019 Oct;74(10):999-1002. doi: 10.1136/thoraxjnl-2019-213338. Epub 2019 Jul 30.

DOI:10.1136/thoraxjnl-2019-213338

PMID:31363020

Abstract

Lymphangioleiomyomatosis can be associated with reversible airflow obstruction and although no guidelines around reversibility testing or inhaled therapy exist, many patients receive bronchodilators and inhaled corticosteroids. To better identify those who may benefit, we examined bronchodilator reversibility and inhaled therapy in a national cohort of 213 subjects. 20% of those tested had airway reversibility by standard criteria. 55% of patients used 13 different combinations of bronchodilators and inhaled corticosteroids. Increasing inhaler classes were associated with reversibility and more rapid FEV decline. Reversibility testing should be performed in all patients and inhaled therapy should be formally studied.

摘要

淋巴管平滑肌瘤病可伴有可逆性气流阻塞，虽然目前尚无关于可逆性检测或吸入治疗的指南，但许多患者仍接受支气管扩张剂和吸入性皮质类固醇治疗。为了更好地确定可能从中受益的患者，我们在一个由 213 名受试者组成的全国性队列中研究了支气管扩张剂的可逆性和吸入治疗。按标准标准，20%的受试者有气道可逆性。55%的患者使用了 13 种不同的支气管扩张剂和吸入性皮质类固醇组合。吸入器种类的增加与可逆性和更快的 FEV 下降有关。应在所有患者中进行可逆性检测，并应正式研究吸入治疗。