Madan Karan, Suri Tejas M, Mittal Saurabh, Maturu Venkata Nagarjuna, Pattabhiraman V R, Mohan Anant, Srinivasan Arjun, Sivaramkrishnan Mahadevan, Prasad K T, Agarwal Ritesh, Tiwari Pawan, Hadda Vijay, Mehta Ravindraz, Guleria Randeep
Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences, New Delhi, India.
Department of Pulmonology, Yashoda Hospitals, Hyderabad, Telangana, India.
Lung India. 2021 Nov-Dec;38(6):524-528. doi: 10.4103/lungindia.lungindia_741_20.
Bronchial thermoplasty (BT) is a treatment option for patients with severe asthma. BT involves controlled delivery of radiofrequency energy using a bronchoscopic catheter, thereby reducing bronchial hyperreactivity. Herein, we describe our experience on the safety and efficacy of BT in severe asthma.
This was a retrospective multicenter study of subjects who underwent BT at four centers across India.
We included 36 subjects (mean ± standard deviation [SD] age, 50.9 ± 11.5 years, women [69.44%]) undergoing 105 BT treatment sessions. All the subjects met the American Thoracic Society/European Respiratory Society criteria for severe asthma, 22.2% were requiring oral maintenance glucocorticoids. The mean ± SD baseline %predicted forced expiratory volume in one second (FEV1) was 62.07 ± 18.54. The median interquartile range (IQR) annual asthma exacerbation rate in the year preceding BT was 3.5 (1-10). We encountered intraprocedural complications in 7 (6.7%) sessions. An exacerbation of asthma following BT occurred in 6 (5.7%) procedures. We observed a significant improvement in the asthma control test and the asthma control questionnaire scores following BT. The quality of life (asthma quality of life questionnaire) also significantly improved. We noted a significant reduction in the number of exacerbations following BT (median [IQR], 3 [1-10] per year pre-BT versus 0.5 [0-3] per year post-BT, P < 0.001). No significant change occurred in the %predicted FEV1 following BT.
BT is a feasible treatment option in patients with severe asthma. More extensive studies are required to establish the efficacy of BT in real-life settings.
支气管热成形术（BT）是重度哮喘患者的一种治疗选择。BT通过支气管镜导管控制输送射频能量，从而降低支气管高反应性。在此，我们描述我们在BT治疗重度哮喘的安全性和有效性方面的经验。
这是一项对印度四个中心接受BT治疗的受试者进行的回顾性多中心研究。
我们纳入了36名受试者（平均±标准差[SD]年龄，50.9±11.5岁，女性占[69.44%]），共进行了105次BT治疗。所有受试者均符合美国胸科学会/欧洲呼吸学会重度哮喘标准，22.2%的患者需要口服维持糖皮质激素。BT前一秒用力呼气量（FEV1）的平均±SD预测值百分比为62.07±18.54。BT前一年哮喘年发作率的中位数四分位间距（IQR）为3.5（1 - 10）。我们在7次（6.7%）治疗中遇到了术中并发症。BT后有6次（5.7%）治疗出现哮喘加重。我们观察到BT后哮喘控制测试和哮喘控制问卷评分有显著改善。生活质量（哮喘生活质量问卷）也有显著改善。我们注意到BT后发作次数显著减少（中位数[IQR]，BT前每年3次[1 - 10次]，BT后每年0.5次[0 - 3次]，P < 0.001）。BT后预测FEV1百分比无显著变化。
BT是重度哮喘患者可行的治疗选择。需要更广泛的研究来确定BT在实际临床环境中的疗效。
