在诊断职业喘的特定吸入挑战期间,持续使用吸入性皮质类固醇治疗的影响
Gabriel Lavoie1, Catherine Lemière1
1Chest Department, CIUSSS du Nord-de-l'île-de-Montréal, Montréal, QC, Canada; Chest Department, Université de Montréal, Montréal, QC, Canada.
The journal of allergy and clinical immunology. In practice
|August 2, 2024
概括
在特定的吸入挑战 (SIC) 期间持续吸入皮质类固醇 (ICS) 并没有改变喘反应或呼吸道炎症. 这一发现挑战了目前用于诊断敏感剂诱导性职业喘 (SIOA) 的指南.
科学领域:
- 职业医学 职业医学是专业的.
- 肺部病理学 肺部病理学
- 过敏和免疫学 过敏和免疫学
背景情况:
- 特定吸入挑战 (SIC) 是诊断敏感剂诱导职业喘 (SIOA) 的黄金标准.
- 目前的指导方针建议在SIC发生前72小时停止吸入性皮质类固醇 (ICS).
- 在SIC期间持续的ICS治疗对诊断结果的影响尚未完全理解.
研究的目的:
- 评估SIC期间持续ICS治疗对关键喘标志物的影响.
- 为了评估FEV1,甲胆PC20和唾液中异氨基酸的变化.
- 为了比较ICS治疗和前不使用类固醇的患者之间的SIC结果.
主要方法:
- 从1999-2022年对SIOA诊断数据的回顾性分析.
- 在测试期间使用ICS的患者和先前未使用类固醇的患者之间的SIC结局的比较.
- 分析包括FEV1,PC20和唾液中氨基酸细胞的数量.
主要成果:
- 与未服用类固醇患者 (27.5%) 相比,接受ICS治疗的患者中,SIC阳性患者比例较高 (39.6%).
- 持续的ICS治疗没有影响SIC的整体结果.
- 两组之间没有观察到FEV1,PC20变化或唾液中氨基酸细胞数量的显著差异.
结论:
- 在SIC期间持续使用ICS似乎不会影响喘反应的发生.
- 持续进行ICS治疗后,呼吸道响应能力和暴露后的异性炎症保持不变.
- 这些发现表明,在长期治疗的患者中,ICS可能不需要停止ICS.
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