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阻塞性睡眠呼吸暂停是哮喘控制的决定因素,与吸烟、反流和鼻炎无关。

Obstructive sleep apnea is a determinant of asthma control independent of smoking, reflux, and rhinitis.

机构信息

From the University of Health Sciences Atatürk Chest Diseases and Chest Surgery Education and Research Hospital, Department of Chest Diseases, Ankara, Turkey.

University of Health Sciences Atatürk Chest Diseases and Chest Surgery Education and Research Hospital, Division of Immunulugy and Allergy, Department of Chest Diseases, Ankara, Turkey.

出版信息

Allergy Asthma Proc. 2021 Jan 1;42(1):e25-e29. doi: 10.2500/aap.2021.42.200098.

Abstract

Asthma control is defined as to what extent manifestations of asthma can be observed in a patient or have been reduced or removed by treatment. Regular use of asthma treatments, correct inhaler technique, adequate information provided about the patient's diseases and medicines, and patient-clinician collaboration aid asthma control. Asthma shares risk factors and links in the pathogenesis with obstructive sleep apnea (OSA), and OSA may aggravate asthma symptoms. To assess the risk of OSA for asthma control. The study was carried out in subjects with asthma who were followed up at specific time points and who used asthma medication regularly and with an appropriate inhaler technique. An asthma control test and a questionnaire were used to determine the asthma control levels and OSA risk of the subjects. With regard to the questionnaire scoring, 77 of 137 subjects with asthma had a low OSA risk and 60 had a high OSA risk. The proportion of the subjects with a high OSA risk (p < 0.001) and were smokers (p = 0.020) were significantly higher in the subjects with uncontrolled asthma than in those with controlled asthma. Logistic regression analysis showed that the variables that affect asthma control status were the risk of OSA and obesity. The subjects with a low OSA risk were more likely to have controlled asthma than those with a high OSA risk (odds ratio 7.896 [95% confidence interval, 2.902-21.487]; p < 0.001). In the subjects with asthma and who adhered to therapy and used inhalers with the correct technique, a high risk of OSA was associated with poor control of their asthma. This association was independent of other factors, including rhinitis, gastroesophageal reflux, and smoking.

摘要

哮喘控制是指在患者中观察到的哮喘表现的程度,或者通过治疗已经减轻或消除。定期使用哮喘治疗药物、正确的吸入器技术、向患者提供充分的关于疾病和药物的信息以及医患合作有助于哮喘控制。哮喘与阻塞性睡眠呼吸暂停(OSA)在发病机制上具有共同的危险因素和联系,而 OSA 可能会加重哮喘症状。为了评估 OSA 对哮喘控制的风险。这项研究在特定时间点接受随访的、定期使用哮喘药物且采用适当吸入器技术的哮喘患者中进行。使用哮喘控制测试和问卷来确定患者的哮喘控制水平和 OSA 风险。就问卷评分而言,在 137 名哮喘患者中,有 77 名患者的 OSA 风险较低,有 60 名患者的 OSA 风险较高。与控制良好的哮喘患者相比,控制不良的哮喘患者中 OSA 风险较高(p < 0.001)和吸烟者(p = 0.020)的比例明显更高。Logistic 回归分析显示,影响哮喘控制状况的变量是 OSA 风险和肥胖。与 OSA 风险较高的患者相比,OSA 风险较低的患者更有可能控制良好的哮喘(比值比 7.896 [95%置信区间,2.902-21.487];p < 0.001)。在坚持治疗且使用正确技术的吸入器的哮喘患者中,OSA 风险高与哮喘控制不佳相关。这种关联独立于其他因素,包括鼻炎、胃食管反流和吸烟。

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