Abstract
Objectives : To determine the risk factors associated with persistent airflow limitation in patients with asthma. Method s: This study was designed and carried out in the department of respiratory medicine, fourth People’s Hospital of Jinan City, Shandong province, China between Jan 2012 and Dec 2012. Three hundred and six asthma patients participating in the study were divided into persistent airflow limitation group (PAFL) and no persistent airflow limitation group (NPAFL). The patients participated in pulmonary function tests and sputum induction examination. The clinical data including age, gender, onset age, disease course, smoking history, family history, regular corticosteroid inhalation, hospitalization history and presence of atopy were collected. Results : In 306 patients, 128 (40.5%) were included in PAFL group and 178(59.5%) in NPAFL group. Multivariate analysis demonstrated smoking (≥10 pack-years; OR, 7.1; 95% CI, 1.8 to 31.2), longer asthma duration (≥ 20years) (OR, 6.3; 95% CI, 1.7 to 28.5), absence of regular corticosteroid inhalation (OR, 3.5; 95% CI, 1.1 to 14.5) and neutrophil in induced sputum≥65% (OR, 1.8; 95% CI, 1.0 to 2.8) were independent risk factors for PAFL. Conclusions : Smoking, longer asthma duration and increased neutrophil in induced sputum are risk factors for PAFL, while regular corticosteroid inhalation is protective factor. Smoking cessation and regular corticosteroid inhalation may play an important role in preventing the occurrence of persistent airflow limitation group (PAFL).
Highlights
Asthma is a common inflammatory disease of airways characterized by reversible airflow obstruction.[1]
The initial percent predicted forced expiratory volume in 1 second (FEV1) was significantly lower in the persistent airflow limitation group (PAFL) group than that in no persistent airflow limitation group (NPAFL) group (P=0.000, independent 2-sample t test)
The ratio of FEV1/forced vital capacity (FVC) in initial and 3 or 12 months after enrollment was significantly lower in PAFL than NPAFL group
Summary
Asthma is a common inflammatory disease of airways characterized by reversible airflow obstruction.[1] In most patients, the symptom of airflow obstruction can be completely reverse after treatment. The chronic, persistent airflow limitation (PAFL) is reported to occur in patients with asthma as a function of severity and/or duration of disease.[1,2] In addition, the incidence of PAFL is very high. In the study of 152 patients with severe asthma, ten Brinke advocated PAFL is associated with adult onset of the disease, airway hyper responsiveness and sputum eosinophilia.[3] Lee suggested that older age, male gender, black ethnicity, current or past smoking, aspirin sensitivity and longer asthma duration were risk factors for PAFL.[1] Modification of the factors causing PAFL may be critical in preventing morbidities in patients with severe asthma. Up to date, the risk factors causing PAFL are still not complete clear
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