基线强迫振荡技术可预测成年哮喘患者病情不会加重：一项为期 12 个月的前瞻性研究。

IF 5.8 2区医学 Q1 ALLERGY

Annals of Allergy Asthma & Immunology Pub Date : 2025-02-01 DOI:10.1016/j.anai.2024.09.018

Yoshito Miyata MD, PhD, Akihiko Tanaka MD, PhD, Takaya Ebato MD, PhD, Ayaka Kashima MD, Makoto Nojo MD, Tomohiro Matsunaga MD, PhD, Keisuke Kaneko MD, PhD, Tomoko Okazaki MD, Shin Ohta MD, PhD, Tetsuya Homma MD, PhD, Yoshio Watanabe MD, PhD, Sojiro Kusumoto MD, PhD, Shintaro Suzuki MD, PhD, Hironori Sagara MD, PhD

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引用次数: 0

摘要

背景：强迫振荡技术（FOT）是一种在静息通气状态下评估哮喘的微创测试。然而，它在临床缓解等纵向评估中的作用仍不明确：本研究旨在纵向评估哮喘临床缓解情况，并确定从基线 FOT 开始 12 个月后预测临床缓解的参数：本前瞻性观察研究招募了 2022 年 4 月至 2023 年 5 月期间在我校医院就诊的成人哮喘患者。入组后对他们进行为期 12 个月的评估，以确定他们是否符合临床缓解标准：入组时和 12 个月内哮喘控制测试评分≥20 分，12 个月内无哮喘加重，12 个月内未定期口服皮质类固醇。分析了入组时的 FOT 参数与临床缓解的关系：结果：94 名哮喘患者完成了研究，并被分为临床缓解组和非临床缓解组。对两组患者的肺功能测试（包括 FOT）进行比较后发现，两组患者在 5 赫兹和 20 赫兹阻力（R20）方面存在显著差异，但在 FEV1 方面无显著差异。多变量逻辑回归分析显示，R20 与临床缓解相关，R20 的调整 ORs 为 0.32（95% CI：0.12-0.91，P=0.033）：R20是预测哮喘患者未来病情加重的有效指标。这些发现可能有助于评估FEV1正常的成年哮喘患者。

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Baseline forced oscillation technique predicting lack of exacerbations in adult patients with asthma

Background

The forced oscillation technique (FOT) is a minimally invasive test to evaluate asthma during resting ventilation. However, its role in longitudinal assessments, such as clinical remission, remains unclear.

Objective

To longitudinally assess asthma clinical remission and identify parameters that predict clinical remission at 12 months from baseline FOT.

Methods

Adult patients with asthma at our university hospital between April 2022 and May 2023 were enrolled in this prospective observational study. They were evaluated for 12 months after enrollment to determine whether they met the following clinical remission criteria: asthma control test score of more than or equal to 20 at enrollment and 12 months, no asthma exacerbations for 12 months, and no regular oral corticosteroid use during the 12 months. FOT parameters at enrollment were analyzed for associations with clinical remission.

Results

A total of 94 patients with asthma completed the study and were categorized into clinical and nonclinical remission groups. Comparison of pulmonary function tests, including the FOT, between the 2 groups revealed significant differences in resistance at 5 Hz and resistance at 20 Hz (R20) but not in forced expiratory volume in 1 second. Multivariate logistic regression analysis revealed that R20 was associated with clinical remission, with adjusted odds ratios of 0.32 (95% CI: 0.12-0.91, P = .033) for R20.

Conclusion

R20 can be a useful predictor of future exacerbations in patients with asthma. These findings may assist in evaluating adult patients with asthma and normal forced expiratory volume in 1 second.

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来源期刊

Annals of Allergy Asthma & Immunology 医学-过敏

CiteScore

6.50

自引率

6.80%

发文量

437

审稿时长

33 days

期刊介绍： Annals of Allergy, Asthma & Immunology is a scholarly medical journal published monthly by the American College of Allergy, Asthma & Immunology. The purpose of Annals is to serve as an objective evidence-based forum for the allergy/immunology specialist to keep up to date on current clinical science (both research and practice-based) in the fields of allergy, asthma, and immunology. The emphasis of the journal will be to provide clinical and research information that is readily applicable to both the clinician and the researcher. Each issue of the Annals shall also provide opportunities to participate in accredited continuing medical education activities to enhance overall clinical proficiency.