哮喘联盟

   摘要
   背景:哮喘是一种常见的慢性疾病, 可在任何年龄发病。最近的聚类分析表明哮喘患者可分为不同的表型，哮喘的发病年龄是一个关键的决定因素。有过敏性疾病的儿童并发哮喘的预后是相对明确的，然而成年后新发哮喘的预后仍是未知。
   方法:我们进行了系统回顾以评估成年后新发哮喘的长期预后。标准为 (组1) : 1. 成年的新发哮喘, 2. 在第一次随访1年内医生确诊哮喘 (包括客观的肺部功能)  3. 随访至少5年, 4. 随访中有客观的肺功能评价，5.不是对比实验。另一组研究(组2)采用不严格的标准收集。
   结果:本次系统回顾的主要结果对成年后确诊的新发哮喘预后的证据数量是非常有限的。 只有一项研究 (n=250)达到相关标准（组1)，它表明成年后新发哮喘的五年预后可能是不乐观的,患者哮喘症状有缓解的比例低于5%。而且，六个额外的研究 (n=964) 也证实了这个结果，主要包括成年新发哮喘(组2)。这些研究有不同的研究终点并且结论不能进行综合。
   结论:为了解成年后新发哮喘的预后因素，需要募集更多成年后新发哮喘病例的随访结果进行研究。


 

（苏欣 审校）
Respir Med. 2015 May 21. pii: S0954-6111(15)00155-9. doi: 10.1016/j.rmed.2015.05.001. [Epub ahead of print]

 

Prognosis of new-onset asthma diagnosed at adult age.
 

Tuomisto LE1, Ilmarinen P2, Kankaanranta H3.
 

Abstract
BACKGROUND:Asthma is a common chronic disease, which can affect patients at any age. Recently, cluster analyses have suggested that patients with asthma can be divided into different phenotypes and that the age at the onset of the disease is a critical defining factor. The prognosis of allergic childhood-onsetasthma is relatively well known, whereas the prognosis of adult-onset asthma remains unclear.
METHODS:We undertook a systematic review to identify studies that evaluated the long-term prognosis of new-onset asthma diagnosed at adult age. Criteria used (set 1) were: 1. adult-onset asthma, 2. physician diagnosed asthma (including objective lung-functions) < 1 year before the first visit, 3. follow-up time of at least 5 years, 4. objective lung function measurements used at follow-up and 5. not a comparative trial. Another set of studies (set 2) with less strict criteria were gathered.
RESULTS:The main result of this systematic review is that the amount of evidence on the prognosis of new-onset asthma diagnosed at adult age is very limited. Only one study (n = 250) fulfilled the criteria (set 1) and it suggests that the five-year prognosis of new-onset asthma diagnosed at adult age may not be favorable, the proportion of patients being in remission was less than 5%. Furthermore, six additional follow-up studies (n = 964) were identified including mainly patients with adult-onset asthma (set 2). These studies had variable endpoints and the results could not be combined.
CONCLUSION:Further follow-up studies that recruit patients with new-onset adult asthma are needed to understand the prognostic factors in adult-onset asthma.
 

Respir Med. 2015 May 21. pii: S0954-6111(15)00155-9. doi: 10.1016/j.rmed.2015.05.001. [Epub ahead of print]