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常规哮喘治疗方案对胸闷变异性哮喘患者的疗效:一项为期1年的多中心、前瞻性、真实世界研究。

Response of patients with chest tightness variant asthma with routine asthma treatment regimen: A 1-year multicenter, prospective, real-world study.

作者信息

Yan Fugui, Li Wen, Guan Wei-Jie, Chen Min, Qiu Chen, Tang Wei, Liu Xiansheng, Xiang Xudong, Li Jing, Jin Meiling, Dai Yuanrong, Chen Ping, Wu Xiaohong, Qiu Zhongmin, Dong Liang, Zhao Limin, Lin Xiaoping, Wu Changgui, Wu Bin, Yuan Yalian, Shi Fei, Zhang Ting, Zhou Jun, Xie Min, Fang Xiaoyu, Zhang Hongliang, Xiao Bing, Xian Mo, Wang Jian, Qiu Zhangwei, Lin Jie, Ji Bingbing, Zhou Yong, Li Yu, Liu Chunhong, Chen Yiping, Zeng Yiming, Liu Lingli, Hua Wen, Huang Huaqiong, Zhou Jiesen, Hu Yue, Che Luanqing, Ying Songmin, Chen Zhihua, Zhong Nanshan, Shen Huahao

机构信息

Key Laboratory of Respiratory Disease of Zhejiang Province, Department of Respiratory Medicine, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.

Department of Respiratory Medicine, State Key Laboratory of Respiratory Disease, Guangzhou Institute for Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.

出版信息

Clin Transl Med. 2020 Sep;10(5):e178. doi: 10.1002/ctm2.178.

Abstract

BACKGROUND

Asthmatic patients with chest tightness as their only presenting symptom (chest tightness variant asthma [CTVA]) have clinical characteristics of eosinophilic airway inflammation similar to those of classic asthma (CA); however, whether CTVA has similar response to antiasthma treatment as compared with CA remains unclear.

OBJECTIVE

The response of 76 CTVA patients to standard asthma treatments with inhaled corticosteroids with long-acting beta-agonists was explored in a 52-week multicenter, prospective, real-world study.

RESULTS

After 52 weeks of treatment with therapy regimens used for CA, the mean 5-point Asthma Control Questionnaire (ACQ-5) score decreased markedly from 1.38(first administration) to 0.71 (52 weeks, mean decrease: 0.674, 95%CI: 0.447-0.900, P<.001).The mean asthma quality-of-life questionnaire (AQLQ) score increased from 5.77 (first administration) to 6.20 (52 weeks, mean increase: 0.441, 95% CI 0.258-0.625, P<.001). Furthermore, at week 52, FVC, FEV %, the diurnal variation in PEFand the PD20-FEV were significantly improved. Subgroup analysis revealed that the patients at first administration in the responsive group had higher ACQ-5 scores than those in the nonresponsive group (P < .05).

CONCLUSION

In conclusion, patients with CTVA had a good therapeutic response to the guideline-recommended routine treatment (containing inhaled corticosteroids). The association between the treatment response and the severity of CTVA suggested that CTVA patients with higher ACQ-5 scores had better therapeutic effects.

摘要

背景

以胸闷为唯一表现症状的哮喘患者(胸闷变异性哮喘[CTVA])具有与典型哮喘(CA)相似的嗜酸性气道炎症临床特征;然而,与CA相比,CTVA对抗哮喘治疗的反应是否相似仍不清楚。

目的

在一项为期52周的多中心、前瞻性、真实世界研究中,探讨76例CTVA患者对吸入糖皮质激素联合长效β受体激动剂的标准哮喘治疗的反应。

结果

采用CA治疗方案治疗52周后,哮喘控制问卷(ACQ-5)平均5分评分从1.38(首次给药)显著降至0.71(52周,平均下降:0.674,95%CI:0.447-0.900,P<0.001)。哮喘生活质量问卷(AQLQ)平均评分从5.77(首次给药)增至6.20(52周,平均增加:0.441,95%CI 0.258-0.625,P<0.001)。此外,在第52周时,用力肺活量(FVC)、第1秒用力呼气容积占预计值百分比(FEV%)、呼气峰流速(PEF)日间变异率和使FEV下降20%所需的组胺累积剂量(PD20-FEV)均显著改善。亚组分析显示,反应组首次给药时的患者ACQ-5评分高于无反应组(P<0.05)。

结论

总之,CTVA患者对指南推荐的常规治疗(含吸入糖皮质激素)有良好的治疗反应。治疗反应与CTVA严重程度之间的关联表明,ACQ-5评分较高的CTVA患者治疗效果更好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/401a/7503098/cc0e4211b6b2/CTM2-10-e178-g001.jpg

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