Changes in forced expiratory volume in 1 second over time in patients with controlled asthma at baseline
Changes in forced expiratory volume in 1 second over time in patients with controlled asthma at baseline
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DOI：
10.1016/j.rmed.2014.04.014
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发表时间：
2014-07-01
影响因子：
4.3
通讯作者：
Yamamoto, Nobuyuki
中科院分区：
文献类型：
--
作者：
Matsunaga, Kazuto;Ichikawa, Tomohiro;Yamamoto, Nobuyuki
背景：哮喘的一个主要特征是第一秒用力呼气量(FEV1)下降速度加快，但受控哮喘患者中这种变化及其相关因素的数据尚不清楚。方法：根据全球哮喘倡议指南入选140名受控哮喘患者。我们检验了一项关于哮喘控制与FEV1随时间变化的关系的前瞻性分析的数据。结果：128名患者完成了3年的随访评估。FEY的平均变化率为22.2mLYR(-1)，变化水平有显著差异。患者之间对下降率的标准差为34.1mLYR(-1)。接下来，我们将低于25%的受试者归类为快速下降者，将大于25%的受试者归类为非快速下降者。在三年的时间里，哮喘控制测试分数的下降，快速下降者高于非快速下降者(p<；0.001)。快速下降者更有可能年龄较大，FeNO水平较高，并且在研究期间有严重的恶化。与未加重的患者相比，有严重加重的患者的FEV1年下降幅度更大(-13.6mLyr(-1)比-53.2mLyr(-1)，p<；0.0001)。结论：在基线控制的哮喘患者中，FEV1的变化率具有很高的变异性。严重的恶化与肺功能的迅速丧失密切相关。(C)2014爱思唯尔有限公司。保留所有权利。
Background: A predominant feature of asthma is an accelerated rate of decline in forced expiratory volume in 1 s (FEV1), but data on the variability and factors associated with this change in patients with controlled asthma are largely unknown.Methods: 140 patients with controlled asthma were enrolled based on the Global Initiative for Asthma guidelines. We examined the data of a prospective analysis of the association between asthma control and change in FEV1 over time.Results: A 3-year follow-up assessment was completed in 128 patients. The mean rate of change in FEY, was a decline of 22.2 mL yr(-1), with significant variation in the levels of change. The between patient standard deviation for the rate of decline was 34.1 mL yr(-1). We next classified the subjects of less than the 25th percentile as rapid decliners, and greater than the 25th percentile as non-rapid decliners. The decrease in the Asthma Control Test score over a 3-year period was higher for rapid decliners than that for non-rapid decliners (p < 0.001).The rapid decliner was more likely to be older, to have higher levels of FeNO, and to have had severe exacerbations during the study. Patients with severe exacerbations had a greater annual decline in FEV1 compared to patients with no exacerbations (-13.6 vs. -53.2 mL yr(-1), p < 0.0001).Conclusions: Among patients with controlled asthma at baseline, the rate of change in FEV1 is highly variable. Severe exacerbations are strongly associated with a rapid loss of lung function. (C) 2014 Elsevier Ltd. All rights reserved.