Bronchiectasis in severe asthma Clinical features and outcomes
Bronchiectasis in severe asthma Clinical features and outcomes
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DOI：
10.1016/j.anai.2018.02.016
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发表时间：
2018-04-01
影响因子：
5.9
通讯作者：
Quirce, Santiago
中科院分区：
文献类型：
--
作者：
Coman, Isabel;Pola-Bibian, Beatriz;Quirce, Santiago
背景资料：支气管扩张在严重哮喘患者中越来越多地被发现，并可能导致疾病的严重程度。目的：确定支气管扩张在严重哮喘患者人群中的患病率，并更好地描述这些患者的临床特征及其结局。方法：我们回顾性分析了184例确诊为重度哮喘的患者的医疗档案，这些患者接受了高剂量的结果：支气管扩张86例（47%），支气管扩张10例（10%），支气管扩张10例（10%），支气管扩张10例（10%）。这些患者同时对非甾体类抗炎药过敏（比值比[OR] 2.24，95%可信区间[CI] 1.00-5.03）和胃食管反流病（OR 1.89，95% CI 1.05-3.41）的发生率高于无支气管扩张的受试者，但异位性皮炎的发生率较低（OR 0.188，95% CI 0.04-0.88）。支气管扩张受试者因哮喘急性发作住院的频率更高（OR 2.09，95% CI 1.08-4.05），血嗜酸性粒细胞水平较高（464 vs 338; P = 0.005）。结论：我们的研究表明，在严重哮喘患者中，支气管扩张的存在与更频繁的住院治疗有关，伴随胃食管反流病、对非甾体抗炎药过敏和血嗜酸性粒细胞计数升高。支气管扩张可能是严重嗜酸性粒细胞性哮喘的另一个表型特征。(C)2018年美国过敏，哮喘和免疫学学院。爱思唯尔公司出版All rights reserved.
Background: Bronchiectasis is increasingly being identified in patients with severe asthma and could contribute to disease severity.Objective: To determine the prevalence of bronchiectasis in a population of patients with severe asthma and to better characterize the clinical features of these patients and their outcomes.Methods: We retrospectively reviewed the medical files of 184 subjects with confirmed severe asthma who had undergone high-resolution thoracic computed tomography and compared the characteristics and outcomes of subjects with and without bronchiectasis.Results: Bronchiectasis was identified in 86 patients (47%). These patients had concomitant hypersensitivity to nonsteroidal anti-inflammatory drugs (odds ratio [OR] 2.24, 95% confidence interval [CI] 1.00-5.03) and gastroesophageal reflux disease (OR 1.89, 95% CI 1.05-3.41) more frequently than subjects without bronchiectasis, but had less atopic dermatitis (OR 0.188, 95% CI 0.04-0.88). Subjects with bronchiectasis were more frequently hospitalized for asthma exacerbations (OR 2.09, 95% CI 1.08-4.05) and had higher blood eosinophil levels (464 vs 338; P =.005) than subjects without bronchiectasis.Conclusion: Our study suggests that in subjects with severe asthma, the presence of bronchiectasis is associated with more frequent hospitalizations, concomitant gastroesophageal reflux disease, hypersensitivity to nonsteroidal anti-inflammatory drugs, and higher blood eosinophil counts. Bronchiectasis could represent an additional phenotypic feature of severe eosinophilic asthma. (C) 2018 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.