NEJM:4倍量增加糖皮质激素吸入用于严重哮喘恶化的临时预防

2018-03-07 zhangfan MedSci原创

研究认为,哮喘恶化高风险患者的自我症状管理过程中,激素吸入量临时性增加4倍可降低患者严重哮喘恶化事件的发生率

哮喘恶化是一种严重危险生命的症状。近日研究人员开展了一种试验性哮喘患者自我管理方式,即在哮喘恶化时临时性4倍增加皮质激素的吸入量以降低哮喘恶化的发生率。

接受吸入激素治疗的哮喘患者参与研究,过去1年中至少有1次疾病恶化经历。患者随机接受临时性4倍激素吸入或对照。研究的主要终点是首次严重哮喘恶化,定义为全身糖皮质激素治疗或计划外哮喘就诊。

1922名患者参与分组,1871人完成研究。分组1年后,4倍剂量组患者严重哮喘恶化发作420次(45%),对照组发作484次(52%),剂量增加组患者首次严重哮喘恶化风险为0.81 (95% CI, 0.71-0.92; P=0.002)。剂量增加组不良事假率增加,但主要是与吸入糖皮质激素相关的局部作用。

研究认为,哮喘恶化高风险患者的自我症状管理过程中,激素吸入量临时性增加4倍可降低患者严重哮喘恶化事件的发生率。

原始出处:

Tricia McKeever et al. Quadrupling Inhaled Glucocorticoid Dose to Abort Asthma Exacerbations. N Engl J Med. March 3, 2018.

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