原標(biāo)題：哮喘第一年治療效果預(yù)測25年后治療預(yù)后
　　背景：本研究是一項對使用類固醇類藥物治療的成人哮喘患者（162名）的隨訪研究，總共歷時25年，調(diào)查哮喘患者病程的治療結(jié)果，探究首個治療年的一秒用力呼氣容積（FEV1）是否可以預(yù)測長期預(yù)后。
　　方法：133名患者（83%）完整地參加了25年的調(diào)查。 在這次隨訪研究中，評估了包括肺功能在內(nèi)的基本哮喘檢查指標(biāo)以及健康相關(guān)生活質(zhì)量問卷（HRQOL），GINA和哮喘控制測試。 本研究哮喘藥物的使用方法，包括藥物的減少與停用，已經(jīng)得到證實可行。
　　結(jié)果：從實驗開始到控制25年后，預(yù)測的平均FEV1%沒有統(tǒng)計學(xué)上的顯著變化。第一年FEV1%的變化可以預(yù)測隨訪結(jié)束時的結(jié)果。如果第一年末的哮喘患者FEV1%是正常的，則可以預(yù)測25年后該患者FEV1%也正常；如果第一年末FEV1%偏低，則25年后FEV1%也偏低。本研究中有29名患者（26.4%）在隨訪期間停止了藥物治療，有6名患者（5.5%）定期使用吸入糖皮質(zhì)激素（ICS）。隨訪結(jié)果顯示16.4%的哮喘患者達(dá)到了臨床緩解，7.6%達(dá)到了功能性緩解。通過健康相關(guān)生活質(zhì)量問卷發(fā)現(xiàn)，哮喘患者在隨訪期間總體生活質(zhì)量保持不變。
　　結(jié)論：在成人哮喘發(fā)作期，首個治療年度達(dá)到的FEV1水平似乎可以預(yù)測將來的肺功能水平。本次隨訪中四分之一的哮喘患者停止了哮喘治療，但他們的HRQOL比那些繼續(xù)使用ICS的患者要好。哮喘患者的臨床緩解率為16%，與其他研究結(jié)果一致。


延伸閱讀
Allergy
The first year of treatment predicts the prognosis of asthma over 25 y—A prospective study
DOI: 10.1111/all.13983
Abstract:
Background: An investigator‐driven, real‐life follow‐up study of adult‐onset steroid‐na?ve, newly diagnosed asthma (162 patients) to investigate the treatment results over the 25‐year course of the disease and whether the first treatment year's forced expiratory volume in one second (FEV1) predicts the long‐term prognosis.
Methods: Eighty‐three per cent of the 133 living patients participated in the 25‐year examinations. At this visit, basic asthma examinations including lung function, as well as questionnaires for health‐related quality of life (HRQoL), GINA and the Asthma Control Test, were used for evaluation. The use of medication and remission was verified.
Results: There was no statistically significant change in mean FEV1% predicted (FEV1%) from baseline to the 25‐year control. The changes in FEV1% during the first year predicted the results at the end of follow‐up. Normal FEV1% at the end of the first year predicted normal FEV1, and below‐normal FEV1% at 1 year predicted below‐normal FEV 1% at 25 years. Twenty‐nine patients (26.4%) had discontinued their medication, and six (5.5%) used ICS periodically. Clinical remission was reached by 16.4% of the patients, and 7.6% reached functional remission. The general HRQoL remained unchanged.
Conclusion: In adult‐onset asthma, the level of FEV1 reached during the first treatment year seems to predict the later lung function level. One quarter of the patients discontinued the asthma treatment, but their HRQoL was better than that of those continuing to use ICS. Clinical remission was reached by 16% of the patients, which is in concordance with other studies.
First Author:
Ritva Kauppinen 
Correspondence:
Jouni Hedman, Department of Pulmonary Diseases, Valto K?kel?nkatu 1, 53130 Lappeenranta, Finland
All Authors:
Ritva Kauppinen, Vesa Vilkka, Harri Sintonen, Jouni Hedman
　　創(chuàng)建過敏性疾病的科研、科普知識交流平臺，為過敏患者提供專業(yè)診斷、治療、預(yù)防的共享平臺。