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长期作用的肌肉抗剂对治疗不受控制的喘的治疗效果使用冲动振荡计进行评估
Hiroyuki Sugawara1,2, Atsushi Saito3, Saori Yokoyama1,2
1Department of Respiratory Medicine and Allergology, Sapporo Medical University School of Medicine, S1W16 Chuoku Sapporo, Sapporo, Hokkaido, 060-8543, Japan.
Respiratory research
|August 7, 2024
概括
在喘治疗中添加长效肌抗体 (LAMA) 显著改善了肺功能和症状. 脉冲振荡计 (IOS) 有效地测量了LAMA诱导的气道变化,显示了所有气道段的好处,特别是在外围.
科学领域:
- 呼吸系统医学 呼吸系统医学
- 药理学 药理学是指药理学的学科.
- 肺功能测试试验 肺功能测试
背景情况:
- 长效肌抗体 (LAMA) 越来越多地被纳入喘治疗中,以改善症状控制.
- 尽管取得了进展,但许多喘患者仍然经历了管理不善的症状.
- 在喘管理中使用脉冲振荡计 (IOS) 对LAMA诱导的气道变化存在有限的研究.
研究的目的:
- 评估用LAMA治疗的控制不良的喘患者的临床反应和呼吸功能.
- 使用IOS调查LAMA诱导的气道变化.
- 与双重治疗 (ICS/LABA) 相比,评估三重治疗 (ICS/LABA/LAMA) 的疗效.
主要方法:
- 42名患有非控制性喘的患者转换为高剂量流他酸/尤克利迪尼/维兰特醇 (FF/UMEC/VI) (ICS/LABA/LAMA).
- 临床评估包括喘控制问卷 (AHQ-33),喘控制测试 (ACT) 和莱斯特咳问卷 (LCQ).
- 在LAMA添加之前和之后,使用螺旋计 (FEV1,MMEF) 和IOS (R20,R5-R20,Fres,AX) 评估呼吸功能.
主要成果:
- 由于呼吸障碍而切换的患者在LAMA后表现出改善的肺功能和IOS参数 (R20,R5-R20,Fres,AX) 的显著变化.
- 对LAMA治疗的响应者 (由于咳) 在所有IOS参数中都表现出显著的改善,与非响应者不同.
- 观察到FEV1,%MMEF,%PEF和所有IOS参数在应答者的基线和治疗后期间之间存在显著差异.
结论:
- 三重疗法 (ICS/LABA/LAMA) 在改善喘症状和肺功能方面优于双重疗法 (ICS/LABA),主要是由于LAMA.
- IOS有效地检测到LAMA诱导的气道改善在所有部分,特别是在外围气道.
- 在现实世界的临床环境中,LAMA对各种喘表型有效,包括那些有呼吸道炎症的喘表型.
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