Antoniou Katerina M, Bolaki Maria, Karagiannis Konstantinos, Trachalaki Athina, Ierodiakonou Despo, Stamatopoulou Vagia, Chatzinikolaou Charito, Mastrodimou Semeli, Stamataki Evangelia, Pitsidianakis George, Lambiri Irini, Mitrouska Ioanna, Spandidos Demetrios A, Tzanakis Nikolaos
Laboratory of Molecular and Cellular Pneumonology, Department of Respiratory Medicine, School of Medicine, University Hospital of Heraklion, University of Crete, 71003 Heraklion, Greece.
Department of Intensive Care Medicine, School of Medicine, University Hospital of Heraklion, University of Crete, 71003 Heraklion, Greece.
Exp Ther Med. 2021 Nov;22(5):1239. doi: 10.3892/etm.2021.10674. Epub 2021 Sep 1.
Asthma diagnosis and management remains a challenging task for the medical community. The aim of the present study was to present the functional and inflammatory profiles of patients with difficult-to-treat asthma in a real-life clinical setting referred to the specialized asthma clinic at the University Hospital of Heraklion. The registry included a cohort of 267 patients who were referred to the severe asthma clinic. Patients were assessed with emphasis on the history of allergies, nasal polyposis or other comorbidities. Blood testing for eosinophils counts and total and specific IgE, and pulmonary function tests were performed at baseline. The median age of patients with asthma was 55 years old, 68.5% were women and 58.3% were never smokers. The vast majority presented with late onset asthma (75.7%), whereas eight (3%) patients were on oral corticosteroids. The median number of exacerbations during the last 12 months was 1 (0-3). Furthermore, 50.7% of patients had a positive serum allergy test, the median eosinophil count was 300 (188-508.5) cells/µl of blood and median total IgE level was 117.5 (29.4-360.5) IU/ml. Patients were retrospectively grouped in the following categories: Group 1, mild-moderate asthma; group 2, patients prescribed a step 4 or 5 asthma therapy according to Global Initiative for Asthma; and group 3, patients on biologic agents. Group 1 had significantly higher FEV1% than groups 2 and 3 (93.4 vs. 79.9 and 79.4%, respectively; P<0.001). Finally, the median Asthma Control Questionnaire 7 (ACQ7) score was 1.14, with patients from groups 2 and 3 presenting higher ACQ7 scores compared with group 1 patients as expected (1.1 and 2.1 vs. 0.7, respectively; P<0.001). To the best of our knowledge, this was the first real-life asthma study in Crete that demonstrated that severe asthmatics predominantly have late-onset asthma with airflow obstruction and uncontrolled symptoms.
哮喘的诊断和管理对医学界来说仍然是一项具有挑战性的任务。本研究的目的是在伊拉克利翁大学医院的专业哮喘诊所所涉及的现实临床环境中，呈现难治性哮喘患者的功能和炎症特征。该登记册纳入了一组转诊至重度哮喘诊所的267名患者。对患者进行评估时重点关注过敏史、鼻息肉或其他合并症。在基线时进行嗜酸性粒细胞计数、总IgE和特异性IgE的血液检测以及肺功能测试。哮喘患者的中位年龄为55岁，68.5%为女性，58.3%从不吸烟。绝大多数患者表现为迟发性哮喘（75.7%），而8名（3%）患者正在使用口服糖皮质激素。过去12个月内发作的中位次数为1次（0 - 3次）。此外，50.7%的患者血清过敏试验呈阳性，嗜酸性粒细胞计数中位数为300（188 - 508.5）个/微升血液，总IgE水平中位数为117.5（29.4 - 360.5）IU/ml。患者被回顾性地分为以下几类：第1组，轻度 - 中度哮喘；第2组，根据全球哮喘防治创议规定接受4级或5级哮喘治疗的患者；第3组，使用生物制剂的患者。第1组的FEV1%显著高于第2组和第3组（分别为93.4%对79.9%和79.4%；P<0.001）。最后，哮喘控制问卷7（ACQ7）评分中位数为1.14，正如预期的那样，第2组和第3组患者的ACQ7评分高于第1组患者（分别为1.1和2.1对0.7；P<0.001）。据我们所知，这是克里特岛第一项现实生活中的哮喘研究，该研究表明重度哮喘患者主要为迟发性哮喘，伴有气流受限和症状控制不佳。
