Eur Respir J:哮喘患者过度使用短效β2受体激动剂会增加病情加重和死亡的风险

2020-01-19 xing.T MedSci原创

由此可见,瑞典有三分之一的哮喘患者每年可收集3个或更多SABA包装盒。SABA过度使用与病情加重和死亡风险增加相关。这些结果强调,监测SABA的使用对改善哮喘的控制至关重要。

过度使用短效β2激动剂(SABA)可能表明哮喘控制不佳和不良健康结局。关于药物使用、危险因素以及SABA(过度使用)对哮喘加重和死亡率的影响数据很少,尤其是基于人群的当代数据,这促使启动全球SABINA(哮喘患者使用SABA)计划。

近日,呼吸疾病领域权威杂志Eur Respir J上发表了一篇研究文章,研究人员通过链接瑞典国家注册局的数据,纳入2006-2014年间年龄在12-45岁的哮喘患者中。SABA过度使用定义为在纳入后的一年基准期内收集了超过2个SABA包装盒。SABA的使用分为3–5、6–10和11+盒/基准年。Cox回归用于评估SABA使用与恶化(住院和/或OCS索赔)和死亡率之间的关联。

该分析纳入了365324例哮喘患者(平均年龄27.6岁;55%的女性),平均随访时间为85.4个月。大约30%的受试者为SABA过度使用,其中21%受试者收集了3–5个包装盒,7%有6-10个包装盒和2%有11+个包装盒。收集到的SABA包装盒数量增加与病情加重的风险增加相关:相比于≤2个包装盒,3-5个包装盒(HR为1.26;[95%CI]为1.24-1.28); 6-10个包装盒(1.44; 1.41-1.46);以及11个以上包装盒(1.77; 1.72–1.83)。较高的SABA使用量会增加死亡率风险(观察到2564例死亡):相比于≤2个包装盒,3–5(HR为1.26; 95%CI为1.14–1.39);6-10(1.67; 1.49-1.87);以及11个以上(2.35;2.02-2.72)。

由此可见,瑞典有三分之一的哮喘患者每年可收集3个或更多SABA包装盒。SABA过度使用与病情加重和死亡风险增加相关。这些结果强调,监测SABA的使用对改善哮喘的控制至关重要。

原始出处:

Bright I. Nwaru,et al.Overuse of short-acting β2-agonists in asthma is associated with increased risk of exacerbation and mortality: A nationwide cohort study of the global SABINA programme.Eur Respir J.2020.https://erj.ersjournals.com/content/early/2019/12/12/13993003.01872-2019

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