在治疗的第一年期间的恶化会影响喘患者的肺功能 - - 一个10年的随访
Pca Almeida1,2, Ev Ponte3, R Stelmach2,4
1Research Lung Function Department, Nottingham BRC, University of Nottingham, Nottingham, United Kingdom.
概括
在严重喘晚期开始吸入皮质类固醇 (ICS) 改善了症状,但显示出不同的肺功能轨迹. 早期恶化预测肺功能下降和未来的事件.
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:
- 吸入性皮质类固醇 (ICS) 是标准的喘治疗,但延迟开始后的长期肺功能影响尚不清楚.
- 严重喘患者经常经历延迟治疗,需要了解肺功能轨迹.
- 之前的研究还没有完全描述以前未经治疗的严重喘患者的肺功能下降,他们迟迟开始ICS治疗.
研究的目的:
- 为了分析严重喘患者的肺功能轨迹,延迟吸入性皮质类固醇 (ICS) 治疗.
- 确定一秒内强迫呼气量 (FEV1) 降低和未来喘恶化的预测因素.
主要方法:
- 在推迟定期ICS治疗开始后,在10年内对184名严重喘患者进行后期分析.
- 使用FEV1计算治疗后一年的绝对肺功能变化 (V1) 和记录的最佳FEV1.
- 分析包括患者人口统计,喘持续时间,阻塞模式和恶化史.
主要成果:
- 54%的受试者经历FEV1下降>25ml/年 (使用V1基线).
- 年轻的患者喘持续时间较短,V1肺功能较好,FEV1绝对下降速度较快.
- 第一年的恶化预测绝对FEV1下降和未来的恶化;较长的未经治疗期间预测相对FEV1下降.
结论:
- 在严重喘中延迟ICS启动导致肺功能轨迹变化,尽管症状有所改善.
- 第一年的恶化是随后肺功能下降和恶化的关键预测因素.
- 没有ICS治疗的时间会影响肺功能丧失的相对速度.
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