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学术前沿

哮喘控制和健康状态的相关性:GOAL研究

发表者:葛秋生 2431人已读

 
 
Bateman等采用随机、双盲、平行研究方法,评价指南衍生的哮喘控制和健康相关生活质量的相关性。北京大学深圳医院儿科葛秋生
作者应用丙酸氟替卡松(fluticasone propionate,FP)和沙美特罗/氟替卡松组合(salmeterol/fluticasone propionate combination,SFC)对尚未控制的哮喘患者进行治疗,以获得最高控制水平,并观察患者健康状态的变化。哮喘控制标准来自GINA定义,包括完全控制(total control,TC)和良好控制(well-controlled,WC),未达到这些水平的定义为未良好控制(not well-controlled,NWC)。健康相关生活质量以哮喘生活质量问卷评价,在研究开始前和每次访视时评估AQLQ。为使患者获得最佳哮喘控制水平,不断增加剂量直至患者完全控制或达到最大剂量。研究发现,治疗后所有患者的AQLQ评分均得到改善,其中获得TC或WC患者的AQLQ评分更高,接近正常水平。各组AQLQ评分自基础值的变化分别为:TC组为(SFC 1.9, FP 1.8),WC组为(SFC 1.5, FP 1.5),而NWC组为(SFC 1.0, FP 0.9),3组间有统计学差异。
综上所述,作者认为以控制哮喘为目标的治疗能够改善健康相关生活治疗至接近正常的水平,而且即便在高水平控制的两组间也存在差异。
 
(韩伟 山东青岛大学附属青岛市立医院东院 266071 摘译)
( Eur. Respir. J, 2007,29: 56-62)
 
 

The correlation between asthma control and health status:
the GOAL study
 
Eur. Respir. J., Jan 2007; 29: 56 - 62.

The present study examined the association between guideline-derived asthma control and health-related quality of life, assessed using the Asthma Quality of Life Questionnaire (AQLQ), in patients with uncontrolled asthma whose treatment was directed towards achieving the highest possible level of control.

The present randomised, double-blind, parallel-group study compared the efficacy of fluticasone propionate (FP) and salmeterol/fluticasone propionate combination (SFC) in achieving two composite, guideline-derived measures of control: total control (TC) and well-controlled (WC) asthma. Not achieving these levels was classed as not well-controlled (NWC). Doses were augmented until patients achieved TC or reached the maximum dose. This dose was maintained for the remainder of the study. AQLQ was assessed at baseline and at each clinic visit.

AQLQ scores improved throughout the study, reaching near-maximal levels in patients achieving TC and WC, and 52-week mean scores in the three control groups were statistically significantly different. Clinically meaningful improvements (mean change from baseline) were: TC group (SFC 1.9, FP 1.8), WC (SFC 1.5, FP 1.5) and NWC (SFC 1.0, FP 0.9).

In conclusion, the treatment aimed at controlling asthma improves the health-related quality of life to levels approaching normal. The difference in Asthma Quality of Life Questionnaire scores between total control and well-controlled confirms that patients distinguish even between these high levels of control.
 

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发表于:2011-08-25 21:39

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