Exacerbations of asthma -: A descriptive study of 425 severe exacerbations
Exacerbations of asthma -: A descriptive study of 425 severe exacerbations
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DOI：
10.1164/ajrccm.160.2.9811100
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发表时间：
1999-08-01
影响因子：
24.7
通讯作者：
Ullman, A
中科院分区：
文献类型：
--
作者：
Tattersfield, AE;Postma, DS;Ullman, A
识别、预防和及时治疗急性发作是哮喘管理的主要目标。我们观察了在12个月平行组研究（FACET）中发生的425例重度急性发作期间PEF、症状和补救性β-受体激动剂的使用的变化，在该研究中，对哮喘患者使用低剂量和高剂量布地奈德联合或不联合福莫特罗进行了比较。口服皮质类固醇用于严重急性加重，主要研究终点，定义为需要口服皮质类固醇（n = 311）或连续两天早晨PEF降低> 30%。从日记卡中获得急性加重前后14天的PEF、症状和支气管扩张剂使用情况。急性加重的特征是PEF在几天内逐渐下降，随后在2 - 3天内变化更快;症状和补救β-激动剂使用的增加平行发生，所有治疗组中变化的严重程度和时程相似。与根据PEF标准确定的急性加重相比，需要口服皮质类固醇确定的急性加重与更多症状和较小的PEF变化相关。女性是与重度急性发作风险增加相关的主要患者特征。急性加重的主要特征可能是症状变化或PEF变化，但其模式不受吸入性皮质类固醇剂量或患者是否服用福莫特罗的影响。
The identification, prevention, and prompt treatment of exacerbations are major objectives of asthma management. We looked at change in PEF, symptoms, and use of rescue p-agonists during the 425 severe exacerbations that occurred during a 12-mo parallel group study (FACET) in which low and high doses of budesonide with and without formoterol were compared in patients with asthma. Oral corticosteroids were prescribed for severe exacerbations, the main study end point, defined as the need for a course of oral corticosteroids (n = 311) or a reduction in morning PEF of > 30% on two consecutive days. PEF, symptoms, and bronchodilator use over the 14 d before and after the exacerbation were obtained from diary cards. Exacerbations were characterized by a gradual fall in PEF over several days, followed by more rapid changes over 2 to 3 d; an increase in symptoms and rescue p-agonist use occurred in parallel, and both the severity and time course of the changes were similar in all treatment groups. Exacerbations identified by the need for oral corticosteroids were associated with more symptoms and smaller changes in PEF than those identified on the basis of PEF criteria. Female sex was the main patient characteristic associated with an increased risk of having a severe exacerbation. Exacerbations may be characterized predominantly by change in symptoms or change in PEF, but the pattern was not affected by the dose of inhaled corticosteroid or by whether the patient was taking formoterol.