JF - European Respiratory Journal JO - Eur Respir J SP - 892 LP - 896 VL - 14is - 4 AU - Ulrik, CS AU - Backer，V Y1 - 1999/10/01 UR - //www.qdcxjkg.com/content/14/4/892.abstract N2 -这项纵向研究的目的是评估患有中度至重度哮喘的成年人中不可逆气流阻塞(NRAO)的频率，比较可逆性和非可逆性气流阻塞哮喘患者1秒用力呼气量(FEV1)的下降。92名(31名男性)终生不吸烟的哮喘患者参与了一项10年随访研究;平均年龄37岁(18-64岁)，哮喘持续时间16岁(2-60岁)。获得包括哮喘药物使用情况在内的病史，并使用标准技术测量包括扩散能力在内的肺功能。入院时，所有患者均有典型症状和可逆性气流阻塞。(NRAO)定义为:预测FEV1 <为80%，预测5mg沙丁胺醇<为9%后deltaFEV1变化。在随访时，共有21例(23%)患者(平均入组年龄32岁)符合NRAO标准;目前的治疗是吸入类固醇(n=21，平均每日剂量1.5 mg)，口服类固醇(n=14)，茶碱(n=20)，口服β - 2激动剂(n=6)和吸入β - 2激动剂。 The patients with NRAO (n=21) had a steeper decline in FEV1 than the remaining patients (n=71, reversible airflow obstruction (RAO)), mean+/-SD 53+/-23 mL x yr(-1) and 36+/-21 mL x yr(-1), respectively (p<0.003). Increasing degree of bronchodilator reversibility (deltaFEV1% pred) at enrolment (p=0.002) and long-term treatment with oral corticosteroids (p=0.009) were associated with an increased risk for the presence of NRAO at follow-up. The comparison of data for NRAO and RAO patients (at follow-up) revealed no significant differences in mean values for total diffusion capacity (TL,CO), diffusion constant (KCO), or total lung capacity. The findings suggest that a subgroup of asthmatics may experience very steep rates of decline in forced expiratory volume in one second leading to severe nonreversible airflow obstruction, whereas no indication was found that long-standing asthma may lead to the development of emphysema. ER -