特异反应性与哮喘控制较差无关
2012/12/24
摘要
前言:特应性是过敏性疾病免疫病理的一部分。然而,特异反应性对成年哮喘患者预后的影响尚不清楚。本试验研究哮喘失控和空气过敏原致敏的关系。鼻炎严重程度与特异反应性的关系也一并进行研究。
方法:639名年龄≥20的哮喘未控制和哮喘未治疗的患者入选本研究。对患者跟踪研究1年,期间采用皮质类固醇联合长效β2受体激动剂吸入治疗,同时检测肺活量,针对空气过敏原进行皮肤针刺试验,记录因哮喘导致的急诊就医。采用哮喘控制问卷调查(ACQ)和哮喘生活质量问卷调查(AQLQ)分别评价哮喘症状和生活质量。同时,评价鼻炎的诊断和严重程度。
结果:基线状态下,特异反应性患者更加年轻、哮喘发作年龄更早。特异反应性和非特异反应性患者之间在性别、体重指数和肺功能上无显著差异。旷课比例高与非特异反应性哮喘临界相关。随访数据显示,特异反应性和非特异反应性哮喘患者,在症状、生活质量、未控制哮喘患者人数、急诊就医、住院、气道阻塞以及治疗反应上无显著差异。特异反应性和非特异反应性患者在鼻炎严重程度上也相似。
结论:总之,针对常见空气过敏原的皮肤针刺试验阳性不是成人哮喘控制的一个预测指标。
(苏楠 审校)
J Asthma. 2012 Oct 26. [Epub ahead of print]
Atopy Is Not Associated with Poor Control of Asthma.
Ponte EV, Souza-Machado A, Souza-Machado C, Franco R, Cruz AA.
Source
Faculdade de Medicina da Bahia , UFBA, Salvador - BA , Brazil.
Abstract
INTRODUCTION:Atopy is part of the immunopathology of allergic diseases; however, the effect of atopy on the prognosis of asthma in adult patients is not established yet. The aim of this study is to investigate whether there is an association between lack of control of asthma and sensitization to aeroallergens. The relation between rhinitis severity and atopy was also investigated.
METHODS:Six hundred and thirty-nine patients aged ≥20 years with uncontrolled and untreated asthma were enrolled. They were followed for 1 year, received inhaled corticosteroids combined with long-acting beta-2 agonists, performed spirometry, skin prick test to aeroallergens, and reported emergency room visits due to asthma. Questionnaires (Asthma Control Questionnaire (ACQ) and Asthma Quality of Life Questionnaire (AQLQ)) were applied to evaluate asthma symptoms and quality of life. Rhinitis diagnosis and severity were evaluated.
RESULTS:Baseline data demonstrated that atopic patients were younger and had earlier onset of asthma. Gender, body mass index, and lung function were similar between atopic and nonatopic patients. Low schooling had a borderline association with nonatopic asthma. Follow-up data demonstrated that there was no significant difference between atopic and nonatopic patients in asthma symptoms, quality of life, frequency of patients with uncontrolled asthma, emergency room visit, hospital admission, airway obstruction, nor response to treatment. Rhinitis severity was also similar between atopic and nonatopic individuals.
CONCLUSIONS:In conclusion, positive skin prick test to common aeroallergens was not found to be predictor of asthma control among adults.、
J Asthma. 2012 Oct 26. [Epub ahead of print]
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