支气管扩展剂反应的流行率,诊断效用和相关特征
Richard Beasley1, Rod Hughes2, Alvar Agusti3
1Medical Research Institute of New Zealand, Wellington, New Zealand.
American journal of respiratory and critical care medicine
|November 29, 2023
概括
在慢性呼吸道疾病中,支气管扩展剂反应率 (BDR) 患病率为18-30%,根据2021年标准较低. BDR与较差的肺功能和症状有关,质疑其对喘的诊断作用.
科学领域:
- 肺部病理学 肺部病理学
- 呼吸系统医学 呼吸系统医学
- 临床试验 临床试验
背景情况:
- 在现实世界慢性呼吸道疾病中,支气管扩展剂响应 (BDR) 的诊断实用性仍然不清楚.
- 喘,喘-COPD重叠和COPD的医生指定的诊断在初级和二级保健中很常见.
研究的目的:
- 调查喘患者中BDR的患病率和诊断意义,喘-COPD重叠,以及COPD.
- 用2005年和2021年欧洲呼吸学会/美国胸腔学会标准来比较BDR患病率.
主要方法:
- 在18个国家进行前性队列研究 (NOVELTY).
- 包括3519名喘患者,833名喘+COPD患者和2436名COPD患者 (年龄≥12岁).
- 使用2005年 (ΔFEV1/FVC ≥12%和≥200ml) 和2021年 (ΔFEV1/FVC>10%预测) 标准计算BDR患病率.
主要成果:
- 使用2021年标准,BDR患病率在18.1%至29.6%之间,略低于2005年标准.
- 在喘患者中,BDR (2021) 与更高的分数呼出的氧化,较低的肺功能,增加的症状和更大的治疗强度相关.
- 在COPD患者中,BDR (2021) 与较低的肺功能和较高的症状负担有关.
结论:
- 在经过治疗的慢性呼吸道疾病中,BDR的患病率为18-30%,在2005年和2021年标准之间存在微小的差异.
- 在诊断组中,BDR与更差的肺功能和更高的症状负担有关.
- 这些发现挑战了BDR作为喘的主要诊断工具的作用,并建议将其视为慢性呼吸道疾病中可治疗的特征.
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