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成人哮喘患者吸入性糖皮质激素短期和长期使用的相关性。一项回顾性分析。

Associations with short-term and long-term use of inhaled corticosteroid in adults with asthma. A retrospective analysis.

作者信息

Pedroso Ariele, Oliveira Joice Mara de, Alves Thainá Bessa, Puzzi Vitória Cavalheiro, Correia Natielly Soares, Ribeiro Heloisa Galdino Gumieiro, Ribeiro Marcos, Furlanetto Karina Couto

机构信息

Universidade Pitágoras Unopar Anhanguera, Research and Postgraduate Center - Londrina (PR), Brazil.

Universidade Estadual de Londrina, Laboratory of Research in Respiratory Physiotherapy - Londrina (PR), Brazil.

出版信息

Rev Assoc Med Bras (1992). 2025 Jul 7;71(6):e20241240. doi: 10.1590/1806-9282.20241240. eCollection 2025.

Abstract

OBJECTIVE

The objective of this study was to compare anthropometric data and pulmonary and extrapulmonary physical functional outcomes of short- and long-term use of inhaled corticosteroids in adults with asthma.

METHODS

This cross-sectional study with retrospective analysis included clinically stable adults with asthma. Anthropometric data, exacerbation history, pulmonary function, disease control, dyspnea in daily life, quality of life, anxiety, depression, functional exercise capacity, performance in daily activities, body composition, physical activity level, respiratory muscle strength, lower limb strength, and handgrip strength were assessed and compared. Participants were separated into two groups based on the current duration of inhaled corticosteroids use below (short-term) or above (long-term) 3 years (≤3 years [n=37] and >3 years [n=30]) for comparative analysis.

RESULTS

A total of 67 participants were analyzed (69% female, 49±14 years, body mass index 29±6 kg/m², FEV1 2.21±0.79 L). The group ≤3 years presented statistically higher spirometric values and exercise capacity compared to the group >3 years even after analysis of covariance adjustments for age, body mass index, disease control, and treatment duration (forced vital capacity 3.39 [3.09-3.70] L vs. 2.93 [2.59-3.26] L, p=0.048; FEV1 2.40 [2.17-2.63] L vs. 2.00 [1.75-2.25] L, p=0.023; 6-min walk test 567 [536-599] vs. 519 [484-554] m, respectively, p=0.048). All the other variables were similar between groups (p>0.05 for all).

CONCLUSION

Participants who used inhaled corticosteroids for more than 3 years exhibited worse pulmonary function and exercise capacity. Despite this, exacerbation history, disease control, quality of life, anxiety, depression, and dyspnea in daily life, among other physical functional outcomes, were similar between short- and long-term use of inhaled corticosteroids in adults with asthma.

摘要

目的

本研究旨在比较哮喘成年患者短期和长期使用吸入性糖皮质激素后的人体测量数据、肺部及肺外身体功能结局。

方法

本横断面研究采用回顾性分析,纳入临床症状稳定的哮喘成年患者。评估并比较人体测量数据、加重病史、肺功能、疾病控制情况、日常生活中的呼吸困难、生活质量、焦虑、抑郁、功能运动能力、日常活动表现、身体成分、身体活动水平、呼吸肌力量、下肢力量和握力。根据目前吸入性糖皮质激素使用时长,将参与者分为两组,使用时长低于3年(短期)或高于3年(长期)(≤3年[n = 37]和> 3年[n = 30])进行对比分析。

结果

共分析了67名参与者(69%为女性,年龄49±14岁,体重指数29±6 kg/m²,第1秒用力呼气容积2.21±0.79 L)。即使在对年龄、体重指数、疾病控制情况和治疗时长进行协方差分析调整后,≤3年组的肺量计测量值和运动能力在统计学上仍高于> 3年组(用力肺活量3.39 [3.09 - 3.70] L对2.93 [2.59 - 3.26] L,p = 0.048;第1秒用力呼气容积2.40 [2.17 - 2.63] L对2.00 [1.75 - 2.25] L,p = 0.023;6分钟步行试验分别为567 [536 - 599]米对519 [484 - 554]米,p = 0.048)。两组间所有其他变量相似(所有p>0.05)。

结论

使用吸入性糖皮质激素超过3年的参与者肺功能和运动能力较差。尽管如此,在哮喘成年患者中,短期和长期使用吸入性糖皮质激素后的加重病史、疾病控制情况、生活质量、焦虑、抑郁以及日常生活中的呼吸困难等其他身体功能结局相似。

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