Peninsula School of Medicine and Dentistry, University of Plymouth, Plymouth, UK.
School of Psychology, University of Plymouth of Plymouth, Plymouth, UK; Research Department, Plymouth Marjon University, UK.
Respir Med. 2020 Feb;162:105870. doi: 10.1016/j.rmed.2020.105870. Epub 2020 Jan 10.
To survey the frequency of extra-pulmonary symptoms reported by a sample of patients with severe asthma, their contribution to quality of life and relationship to treatment pathways.
Consenting patients (N = 100) attending a severe asthma clinic completed questionnaire measures of extra-pulmonary symptoms (the General symptom Questionnaire, GSQ), pulmonary symptoms (Asthma Control Test, ACT), quality of life (the Severe Asthma Questionnaire, SAQ) and health status (EQ-5D-5L).
A median of 21 extra-pulmonary symptoms were reported per week. GSQ correlated -0.65 with the ACT and 0.69 with the SAQ. Linear regression showed that both the ACT and GSQ were significant predictors of SAQ mean score, p < 0.001. In patients not receiving biologics, those with high cumulative OCS exposure (≥1120 mg per year) had significantly worse scores (p < 0.05) on all questionnaires except the ACT and GSQ compared to those with low cumulative OCS exposure.
Extra-pulmonary symptoms were common in this sample of people with severe asthma. Extra-pulmonary and pulmonary symptoms contribute equal variance to the score of HRQoL, showing that they are equally important contributors to patients' experience of severe asthma. Extra-pulmonary symptoms are often overlooked in clinical medicine and in measures of quality of life. Participants receiving biologic treatments had lower extra-pulmonary symptoms possibly indicating that biologics reduce systemic symptoms more effectively than other treatments.
调查一组重度哮喘患者报告的肺外症状频率，及其对生活质量的贡献和与治疗途径的关系。
同意参加的患者（N=100）在重度哮喘诊所完成了肺外症状（一般症状问卷，GSQ）、肺部症状（哮喘控制测试，ACT）、生活质量（重度哮喘问卷，SAQ）和健康状况（EQ-5D-5L）的问卷测量。
每周报告的肺外症状中位数为 21 个。GSQ 与 ACT 呈负相关（-0.65），与 SAQ 呈正相关（0.69）。线性回归显示，ACT 和 GSQ 都是 SAQ 平均得分的显著预测因子，p<0.001。在未接受生物制剂治疗的患者中，与低累积 OCS 暴露（<1120mg/年）相比，高累积 OCS 暴露（≥1120mg/年）的患者在所有问卷（除 ACT 和 GSQ 外）上的评分均显著更差（p<0.05）。
在这个重度哮喘患者样本中，肺外症状很常见。肺外和肺部症状对 HRQoL 的评分贡献相等，这表明它们对患者重度哮喘体验同样重要。肺外症状在临床医学和生活质量测量中常常被忽视。接受生物制剂治疗的患者肺外症状较低，可能表明生物制剂比其他治疗方法更有效地减轻全身症状。
