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症状,未来恶化风险和对支气管炎的长期类药物治疗的反应:一项观察性研究
Oriol Sibila1, Jamie Stobo2, Lidia Perea1
1Department of Respiratory, Hospital Clinic, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, CIBERES, Barcelona, Spain.
支气管切除的每日症状是未来恶化的独立危险因素. 患有严重症状的患者和患有频繁恶化的患者同样受益于类药物治疗.
科学领域:
- 肺病学
- 呼吸系统医学
- 临床研究
背景情况:
- 支气管炎的每日症状被认为是疾病活动和潜在恶化风险的指标.
- 目前的指导方针建议长期治疗每年出现三次或更多次恶化的患者.
- 这项研究调查了症状负担是否独立预测恶化,并确定了额外的宏治疗候选药物.
研究的目的:
- 确定支气管炎的日常症状是否可以独立预测未来的恶化.
- 为了确定是否高症状患者,无论恶化的频率,从长期的类药物治疗中获益.
- 为治疗指南提供有关症状负担在支气管切除治疗中的作用的信息.
主要方法:
- 使用来自EMBARC注册的数据,这是一个多中心的国际支气管病例数据库.
- 使用呼吸道症状评分 (QoL-B-RSS) 评估出发症状,并追踪至少一年的恶化情况.
- 进行了对三项随机对照试验 (BLESS,BAT,EMBRACE) 的后期分析,以评估与宏治疗反应的症状关联.
主要成果:
- 之前的恶化 (RR 1.11) 和症状评分 (RR 1. 10每10点的QoL- B- RSS下降) 都是未来恶化的独立预测因素.
- 症状得分较高但前期恶化不到三次的患者的恶化率与频繁恶化和平均症状的患者相似 (RR 1.58).
- 在患有频繁恶化的患者和患有高症状负担的患者中,需要使用宏类药物治疗以预防恶化患者的数量相似.
结论:
- 每日症状是未来支气管炎症恶化的独立危险因素.
- 患有高症状负担的患者从长期类药物治疗中获得的益处与基线恶化频率高的患者相似.
- 为了优化支气管切断的治疗选择,应考虑与恶化病史一起评估症状.
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