Groupe Hospitalier Sud, Hôpital Haut-Lévêque CHU Bordeaux, Pessac, France.
INSERM U1219 Université de Bordeaux, Bordeaux, France.
Respir Res. 2021 May 4;22(1):136. doi: 10.1186/s12931-021-01723-x.
In France, data regarding epidemiology and management of severe asthma are scarce. The objective of this study was to describe asthma phenotypes using a cluster analysis in severe asthmatics recruited in a real world setting.
The study design was prospective, observational and multicentric. The patients included were adults with severe asthma (GINA 4-5) followed-up in French Non Academic Hospital between May 2016 and June 2017. One hundred and seven physicians included 1502 patients. Both sociodemographic and clinical variables were collected. Hierarchical cluster analysis was performed by the Ward method followed by k-means cluster analysis on a population of 1424 patients.
Five clusters were identified: cluster 1 (n = 690, 47%) called early onset allergic asthma (47.5% with asthma before 12 years), cluster 2 (n = 153, 10.5%): obese asthma (63.5% with BMI > 30 kg/m), cluster 3 (n = 299, 20.4%): late-onset asthma with severe obstructive syndrome (89% without atopy), cluster 4 (n = 143, 9.8%): eosinophilic asthma (51.7% had more than 500 eosinophils/mm), and cluster 5 (n = 139, 9.5%): aspirin sensitivity asthma (63% had severe asthma attacks).
In our population of adults with severe asthma followed by pulmonologists, five distinct phenotypes were identified and are quite different from those mentioned in previous studies.
在法国，有关严重哮喘的流行病学和管理数据稀缺。本研究的目的是通过聚类分析描述严重哮喘患者的表型，这些患者是在真实环境中招募的。
研究设计为前瞻性、观察性和多中心研究。纳入的患者为 2016 年 5 月至 2017 年 6 月在法国非学术医院接受严重哮喘（GINA 4-5）治疗的成年人。107 名医生共纳入 1502 名患者。收集了社会人口学和临床变量。通过 Ward 方法进行层次聚类分析，然后对 1424 名患者进行 k-均值聚类分析。
共鉴定出 5 个聚类：聚类 1（n=690，47%）称为早发性过敏性哮喘（47.5%在 12 岁前患有哮喘），聚类 2（n=153，10.5%）：肥胖哮喘（63.5%的 BMI>30kg/m），聚类 3（n=299，20.4%）：晚发性伴有严重阻塞综合征的哮喘（89%无特应性），聚类 4（n=143，9.8%）：嗜酸性粒细胞性哮喘（51.7%的患者嗜酸性粒细胞>500/mm），聚类 5（n=139，9.5%）：阿司匹林敏感性哮喘（63%的患者有严重哮喘发作）。
在我们的成年严重哮喘患者人群中，由肺病学家进行随访，确定了五种不同的表型，与之前研究中提到的表型有很大的不同。
