摘要
目的分析46例成年人咳嗽变异性哮喘(CVA)的临床特征及影响其复发的因素。方法收集2015年3月—2017年10月复旦大学附属中山医院收治的46例CVA患者的临床资料,并于2022年10月截止最后1例患者的随访,确保每位患者至少随访5年。根据患者5年内随访的最终结果,将患者年均复发次数≥1的纳入高频复发组,共14例;将患者年均复发次数<1的纳入低频复发组,共32例。对两组患者的临床特点进行归纳,同时对患者的各项临床指标进行对比分析,对两组患者显著有差异的指标进行Logistic回归分析,分析归纳影响CVA患者复发的临床因素。结果46例患者的年龄主要集中在65岁以下,女性居多,69.6%的患者BMI异常,82.6%的患者无吸烟习惯,28.3%的患者过敏原检测阳性,71.8%的患者有诱发因素,23.9%的患者从出现至确诊CVA超过1年。大部分患者的初始治疗药物含吸入性糖皮质激素(ICS)+长效β2受体激动剂(LABA),大多数患者的治疗时间不足两个月,78.3%的患者治疗显效,67.4%的患者初始治疗后不再维持治疗。两组患者的临床特征单因素分析得到随访ACT、随访ACQ、ACQ下降(随访-初诊)、FEV1%pred下降(随访-初诊)、FEV50%pred下降(随访-初诊)5个因素有显著差异(P<0.05),经Logistic多因素回归分析显示,ACQ下降为影响成人CVA预后的独立危险因素(P<0.05)。结论FEV1%下降、FEV50%下降及ACQ的差值与CVA复发有相关性,其中ACQ下降是影响成人CVA复发的危险因子(P<0.05),与患者预后有关,而初治小气道功能障碍与CVA复发频率无统计学意义。
Objective To analyze the clinical features of 46 adult patients with cough variant asthma(CVA)and the factors affecting its recurrence.Methods Baseline clinical data of 46 CVA patients admitted to Zhongshan Hospital of Fudan University from March 2015 to October 2017 were collected,and the last patient was followed up in October 2022 to ensure that each patient was followed up for at least 5 years.According to the final results of 5-year follow-up,patients with annual recurrence≥1 were included in the high frequency recurrence group.Patients with annual recurrence less than 1 were included in the low-frequency recurrence group.The clinical characteristics of the two groups of patients were summarized,and the clinical indicators of the patients were compared and analyzed.The indicators with significant differences between the two groups were Logistic regression analysis,and the clinical factors affecting the recurrence of CVA patients were analyzed and summarized.Results The 46 patients were mainly under 65 years of age,mostly female,69.6%had abnormal BMI,82.6%had no smoking habit,28.3%had positive allergen test,71.8%had preexisting factors,and 23.9%had CVA more than 1 year from the onset to the diagnosis.The initial treatment of most patients consisted of inhaled glucocorticoids(ICS)+long-acting β2 receptor agonists(LABA),and the treatment time of most patients was less than two months,78.3%of patients had a significant response,and 67.4%of patients no longer maintained therapy after initial treatment.Unifactor analysis of clinical characteristics of the two groups of patients showed that ACT at return visit,ACQ at return visit,ACQ at return visit-ACQ at first visit(ACQ decreased),FEV1%decreased,FEV50%decreased,and there were significant differences in 5 factors(P<0.05).Logistic multivariate regression analysis showed that,the decrease of ACQ was an independent risk factor for adult CVA prognosis(P<0.05).Conclusion FEV1%decline,FEV50%decline and the difference of ACQ are correlated with CVA recurrence,and the decline of ACQ is a risk factor for adult CVA recurrence(P<0.05),which is related to the prognosis of patients,while there is no statistical significance between small airway dysfunction and CVA recurrence frequency at initial treatment.
作者
成青
崔博
周亚玲
马圆
陈梦捷
高佳萌
陈智鸿
CHENG Qing;CUI Bo;ZHOU Yaling;MA Yuan;CHEN Mengjie;GAO Jiameng;CHEN Zhihong(Department of Respiratory and Critical Care Medicine,Zhongshan Hospital Affiliated to Fudan University,Shanghai 200032,China;Department of Respiratory and Critical Care Medicine,Liqun Hospital of Putuo District,Shanghai 200333,China;Department of Respiratory and Critical Care Medicine,The Fourth People's Hospital of Zigong,Zigong 643000,Sichuan,China)
出处
《西部医学》
2025年第9期1331-1337,共7页
Medical Journal of West China
基金
国家自然科学基金面上项目(82270026)。
关键词
咳嗽变异性哮喘
ACQ
ACT
肺功能
临床特征
预后
Cough variability asthma
Asthma control questionnairve
Asthma control test
Pulmonary function
Clinical features
Prognosis
