FeNO 联合 GINA 指南在成人哮喘吸入性皮质类固醇滴定中的有益作用：一项随机研究。

The beneficial role of FeNO in association with GINA guidelines for titration of inhaled corticosteroids in adult asthma: A randomized study.

机构信息

Department of Internal Medicine, Thanh Hoa General Hospital, Thanh Hoa City, Vietnam.

Department of Public Health, Thang Long University, Hanoi City, Vietnam.

出版信息

Adv Med Sci. 2020 Sep;65(2):244-251. doi: 10.1016/j.advms.2020.03.001. Epub 2020 Apr 7.

DOI:10.1016/j.advms.2020.03.001

PMID:32276003

Abstract

PURPOSE

This study aimed to demonstrate the role of fractional concentration of exhaled nitric oxide (FeNO) in association with Global Initiative for Asthma (GINA) guidelines for treatment of adult patients with asthma.

METHODS

It was a prospective and randomized study. The symptomatic asthmatic patients were randomly divided into two groups: GINA group (followed GINA guidelines; N = 86) or GINA + FeNO group (followed GINA guidelines + FeNO for titration of inhaled corticosteroids - ICS; N = 90). They were followed-up for 9 months.

RESULTS

In GINA group, 37.2% patients had no treatment and 62.8% patients discontinued treatment vs. 40.0% and 60.0% in GINA + FeNO, respectively. After 3, 6 and 9 months of treatment, the percentage of mild, moderate and severe asthma showed no significant difference between the two groups. At 9th month, Δ moderate asthma (reduction) in GINA + FeNO group was significantly higher than in the GINA group (-22.0% vs. -11.6%; P = 0.018). The improvement of asthma control test (ACT) score was not different between the groups at 9th month (12 ± 6 vs. 10 ± 5; P > 0.05); the level of FeNO reduction in GINA + FeNO group was significantly higher than that in GINA group (-42 ± 11 vs. -35 ± 9; P = 0.022). The daily dose of ICS in GINA + FeNO group was significantly lower than that in GINA group (397 ± 171 vs. 482 ± 240 mcg and 375 ± 203 vs. 424 ± 221 mcg; respectively) at the end of 6 and 9 months.

CONCLUSION

The use of FeNO in association with GINA guidelines has a beneficial role for accurate daily dose of ICS in adult patients with asthma.

摘要

目的

本研究旨在展示呼出气一氧化氮（FeNO）分数浓度在成人哮喘患者治疗中与全球哮喘倡议（GINA）指南相结合的作用。

方法

这是一项前瞻性、随机研究。有症状的哮喘患者被随机分为两组：GINA 组（遵循 GINA 指南；N=86）或 GINA+FeNO 组（遵循 GINA 指南+FeNO 滴定吸入性皮质类固醇（ICS）；N=90）。他们接受了 9 个月的随访。

结果

在 GINA 组中，37.2%的患者没有治疗，62.8%的患者停止治疗，而 GINA+FeNO 组分别为 40.0%和 60.0%。治疗 3、6 和 9 个月后，两组轻度、中度和重度哮喘的比例无显著差异。在第 9 个月时，GINA+FeNO 组中度哮喘（减少）的Δ显著高于 GINA 组（-22.0%比-11.6%；P=0.018）。第 9 个月时，两组哮喘控制测试（ACT）评分的改善无差异（12±6 比 10±5；P>0.05）；GINA+FeNO 组 FeNO 降低水平显著高于 GINA 组（-42±11 比-35±9；P=0.022）。GINA+FeNO 组的 ICS 日剂量明显低于 GINA 组（第 6 个月和第 9 个月时分别为 397±171 比 482±240 mcg 和 375±203 比 424±221 mcg）。