Department of General Surgery, University Hospital Lewisham, Lewisham and Greenwich NHS Trust, Lewisham High Street, London, SE13 6LH, UK.
Department of General Surgery, Whittington Hospital, Whittington Health NHS Trust, Magdala Avenue, London, N19 5NF, UK.
Obes Surg. 2021 Apr;31(4):1810-1832. doi: 10.1007/s11695-021-05255-7. Epub 2021 Feb 15.
Obesity is associated with increased severity of asthma. Bariatric surgery can be effective in weight loss and improvement in asthma. Two reviewers conducted a systematic review using search terms: 'weight loss', 'bariatric surgery', and 'asthma'. Adult studies including all bariatric procedures and nonsurgical weight loss regimes were included. Thirty-nine studies, including twenty-six bariatric studies and thirteen nonsurgical studies, were found. No study directly compared bariatric surgery to nonsurgical techniques. Bariatric surgery offered greater weight loss (22-36%) than nonsurgical programmes (4.1-14.2%) and more consistently improved medication use, airway hyperresponsiveness, hospitalisation rate or ED attendance and lung function, while change in inflammatory markers were variable. Bariatric surgery appears to be superior in treating asthma; however, further study on surgery for both mild and severe asthma is required.
肥胖与哮喘严重程度增加有关。减重手术对于减轻体重和改善哮喘非常有效。两位评审员使用“体重减轻”、“减重手术”和“哮喘”等检索词进行了系统评价。包括所有减重手术和非手术减重治疗方案的成人研究均被纳入。共发现 39 项研究，其中 26 项为减重手术研究，13 项为非手术研究。没有研究直接比较减重手术与非手术技术。减重手术比非手术方案（4.1%-14.2%）更能显著减轻体重（22%-36%），并且更能持续改善药物使用、气道高反应性、住院率或急诊就诊率和肺功能，而炎症标志物的变化则各不相同。减重手术在治疗哮喘方面似乎更优；然而，仍需要进一步研究手术治疗轻、重度哮喘的效果。
