在轻度至中度喘的青少年和成年人中,亚型的患病率和治疗影响:系统综述和元分析
Chamard Wongsa1, Pakpoom Wongyikul2,3, Piyaporn Chokevittaya1
1Division of Allergy and Clinical Immunology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
The journal of allergy and clinical immunology. Global
|December 9, 2024
概括
许多患有轻度至中度喘的成年人和青少年患有非氨基酸性喘 (NEA),该喘对吸入性皮质类固醇 (ICS) 的反应不佳. 早期诊断评估对于有效的喘管理至关重要.
科学领域:
- 肺部病理学 肺部病理学
- 过敏和免疫学 过敏和免疫学
- 临床医学 临床医学
背景情况:
- 含有吸入性皮质类固醇 (ICS) 的疗法是标准的喘治疗方法,但对于非乙性喘 (NEA) 通常是无效的.
- 在轻度至中度喘病例中,关于NEA与eosinophilic喘 (EA) 的患病率的数据有限.
研究的目的:
- 系统地审查轻度至中度喘中喘亚型 (EA和NEA) 的患病率.
- 评估不同喘亚型对ICS治疗的反应.
主要方法:
- 对18项关于青少年和成人轻度至中度喘研究的系统综述 (共3533名参与者).
- 唾液炎症细胞分析以将喘分为EA和NEA亚型.
- 在ICS治疗后的亚型之间对治疗结果的比较.
主要成果:
- 估计有40.39%的ICS-naive患者患有轻度至中度喘有NEA.
- 唾液细胞学的重新评估将20-30%最初诊断的NEA患者重新归类为EA.
- EA患者在ICS中表现出显著改善,而NEA患者的反应有限.
结论:
- 轻度至中度喘病例中的很大一部分是NEA,其特点是ICS反应差.
- 建议将喘亚型的彻底诊断评估纳入临床实践.
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