慢性呼吸道疾病:特定治疗和不良反应预防的表型

Karger Kompass Pub Date : 2023-01-01 DOI:10.1159/000533911
Wilmer Alejandro Madrid-Mejía
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摘要

& lt; b>介绍:& lt; / b>吸入皮质类固醇(ICS)在支气管扩张患者中的作用仍然存在争议。使用基线嗜酸性粒细胞计数(绝对和百分比)作为预测ICS在支气管扩张患者中的作用的标志物的证据有限。& lt; b>方法:& lt; / b>在香港一家大型地区医院和三级呼吸转诊中心进行了一项回顾性病例对照研究,包括140名中国非囊性纤维化(CF)支气管扩张患者,以调查具有不同基线嗜酸性粒细胞计数的ICS使用者和非使用者的支气管扩张恶化风险。& lt; b>结果:& lt; / b>ICS使用者发生支气管扩张加重的风险显著降低,校正优势比(OR)为0.461(95%可信区间[CI] 0.225-0.945, <i>p</i>-value 0.035)。对血液嗜酸性粒细胞计数(按百分比)从2%到4%的不同截止点(每次用0.5%的网格)进行单变量逻辑回归。基线嗜酸性粒细胞3.5%被发现是所有指标中最佳的临界值,调整后的OR为0.138 (95% CI = 0.023-0.822, <i>p</i>-value = 0.030)。
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Enfermedades respiratorias crónicas: Fenotipificación para tratamiento específico y prevención de efectos adversos
Introduction: The role of inhaled corticosteroid (ICS) among patients with bronchiectasis remains controversial. There is limited evidence of using baseline eosinophil count (absolute and percentage) as a marker to predict the role of ICS among patients with bronchiectasis. Methods: A retrospective case-control study was conducted in a major regional hospital and tertiary respiratory referral centre in Hong Kong, including 140 Chinese patients with noncystic fibrosis (CF) bronchiectasis, to investigate the exacerbation risks of bronchiectasis among ICS users and nonusers with different baseline eosinophil counts. Results: ICS user had significantly lower risk to develop bronchiectasis exacerbation with adjusted odds ratio (OR) of 0.461 (95% confidence interval [CI] 0.225–0.945, p-value 0.035). Univariate logistic regression was performed for different cut-offs of blood eosinophil count (by percentage) from 2% to 4% (with a 0.5% grid each time). Baseline eosinophil 3.5% was found to be the best cut-off among all with adjusted OR of 0.138 (95% CI = 0.023–0.822, p-value = 0.030).
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