Brandão A Z P, Lasmar L M L B F, Pertence L M A S, Vieira M I R, Lasmar G B, Ganem V O, Mancuzo E V, de Queiroz M V N P
Department of Pediatric Pulmonology, Hospital das Clínicas, Federal University of Minas Gerais, Belo Horizonte, Brazil.
Multidisciplinary Center for Difficult-to-Control Asthma, Hospital das Clínicas, Federal University of Minas Gerais, Belo Horizonte, Brazil.
Clin Transl Allergy. 2025 Apr;15(4):e70046. doi: 10.1002/clt2.70046.
Although exacerbations are common in severe asthma, there have been few longitudinal studies evaluating their effect on lung function parameters. This study aimed to evaluate the impact of exacerbations on lung function in children and adolescents with severe asthma in Brazil.
This was a prospective study in which lung function parameters-forced vital capacity (forced vital capacity [FVC]), forced expiratory volume in 1 s (forced expiratory volume in 1 s [FEV1]), the FEV/FVC ratio, and the forced expiratory flow between 25% and 75% of FVC (FEF), each expressed as a percentage of the predicted value-were measured at 3-month intervals for three years in 64 patients (6-18 years of age) with severe asthma. Multivariate regression models of longitudinal data were employed to assess the associations between exacerbations and other predictors show with lung function parameters.
The mean duration of prior use of an inhaled corticosteroid together with a long-acting bronchodilator or other controller was 6.7 (SD 3.2) years. During the study period, 31 patients (48.5%) had exacerbations. We analyzed 479 pulmonary function tests and found no significant association between exacerbation and any of the lung function parameters: FEV (p = 0.90); FEF (p = 0.73); FEV/FVC (p = 0.29); and FVC (p = 0.51). Passive smoking and being female were associated with mean FEV values that were 9.89% and 7.32% lower, respectively.
In children and adolescents with severe asthma who are using preventive treatment, exacerbations do not seem to be associated with impaired lung function.
尽管哮喘急性加重在重度哮喘中很常见，但很少有纵向研究评估其对肺功能参数的影响。本研究旨在评估急性加重对巴西重度哮喘儿童和青少年肺功能的影响。
这是一项前瞻性研究，对64例（6 - 18岁）重度哮喘患者进行为期三年的随访，每隔3个月测量一次肺功能参数——用力肺活量（FVC）、第1秒用力呼气容积（FEV1）、FEV1/FVC比值以及FVC 25%至75%之间的用力呼气流量（FEF），每个参数均以预测值的百分比表示。采用纵向数据的多变量回归模型来评估急性加重与其他预测因素与肺功能参数之间的关联。
吸入糖皮质激素联合长效支气管扩张剂或其他控制药物的既往平均使用时间为6.7（标准差3.2）年。在研究期间，31例患者（48.5%）出现急性加重。我们分析了479次肺功能测试，发现急性加重与任何肺功能参数之间均无显著关联：FEV1（p = 0.90）；FEF（p = 0.73）；FEV1/FVC（p = 0.29）；FVC（p = 0.51）。被动吸烟和女性与平均FEV1值分别降低9.89%和7.32%相关。
在接受预防性治疗的重度哮喘儿童和青少年中，急性加重似乎与肺功能受损无关。
