在严重喘中探索远程监控的FeNO抑制测试的长期实用性
John Busby1, Joshua Holmes1, Mohammed Almutairi2
1School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK.
概括
微分呼出氧化 (FeNO) 抑制测试 (FeNOSuppT) 是可行的日常护理,并有助于确认最佳的吸入性皮质类固醇使用. 一个积极的FeNOSuppT导致了较少的生物启动,但类似的喘结果.
科学领域:
- 严重喘管理 严重喘管理
- 呼吸系统医学 呼吸系统医学
- 临床的表型化 临床的表型化
背景情况:
- 在开始严重喘的生物疗法之前,最佳的吸入性皮质类固醇 (ICS) 使用至关重要.
- 分数呼出氧化 (FeNO) 抑制试验 (FeNOSuppT) 是一种经过验证的表型化方法,但其长期临床影响尚未得到充分证实.
研究的目的:
- 评估与数字吸入器监测一起实施FeNOSuppT的现实可行性.
- 评估FeNOSuppT对严重喘患者的生物治疗启动和临床结果的影响.
主要方法:
- 在英国的7个严重喘中心进行了前性队列研究.
- 患者使用了启用传感器的ICS/长效β-agonist (LABA) 吸入器,并进行了FeNOSuppT,并评估了积极的结果 (≥42%的FeNO减少).
- 生物学启动和临床结果 (FEV1,喘控制问卷) 在短期和12个月的随访中进行了比较.
主要成果:
- 353名患者中有72.8%完成了FeNOSuppT,其中54.5%的测试结果呈阳性.
- 阳性FeNOSuppT与FEV1和喘控制 (ACQ6) 的显著短期改善相关.
- 在符合条件的患者中,阳性FeNOSuppT与较低的生物启动率 (48.2%与65.2%) 相关,但可比较的长期FEV1,症状控制和恶化率.
结论:
- 在严重喘的标准临床实践中,将FeNOSuppT与数字监控集成是可以实现的.
- 阳性FeNOSuppT结果表明ICS响应的潜力,导致生物启动减少,而不影响长期临床结果.
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