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吸入类固醇和因喘住院的风险
J G Donahue1, S T Weiss, J M Livingston
1Channing Laboratory, Boston, MA, USA. Jim.Donhaue@channing.harvard.edu
JAMA
|March 19, 1997
概括
抗炎性喘治疗,特别是吸入类固醇和cromolyn,显著降低了喘住院的风险. 相反,增加β-激动剂的使用与更高的住院风险有关.
科学领域:
- 肺部医学 肺部医学
- 药理学 药理学是指药理学的学科.
背景情况:
- 喘恶化经常导致住院治疗,对患者和医疗保健系统造成重大负担.
- 确定有效的治疗方法来预防与喘相关的住院治疗对于改善患者的治疗结果至关重要.
研究的目的:
- 评估抗炎性喘药物在降低喘住院风险方面的有效性.
- 为了比较吸入性皮质类固醇和cromolyn对喘恶化的保护作用.
主要方法:
- 一项回顾性队列研究,利用来自马萨诸塞州东部健康维护组织 (HMO) 的数据.
- 对1991年10月至1994年9月期间被诊断患有喘的16941名个人计算机化医疗记录的分析.
- 统计学调整包括使用β-激动剂,年龄,种族,其他喘药物和医疗保健利用等因素.
主要成果:
- 吸入类固醇使用与喘住院风险减少50%有关 (相对风险[RR],0.5;95%信心区间[CI],0.4-0.6).
- 克罗莫林还显示了住院的风险降低,特别是在儿童中 (RR,0.8;95% CI,0.7-0.9).
- 增加β-激动剂的使用与更高的住院风险相关,即使考虑到其他变量.
结论:
- 吸入性皮质类固醇和克罗莫林可对需要住院治疗的喘恶化提供显著的保护.
- 这些发现支持吸入类固醇用于喘患者的使用,这些患者经常使用β-agonists控制症状.
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