■支气管热成形术(BT)可改善重度哮喘患者的临床结果和生活质量,并且在先前的CT研究中显示气道狭窄和空气滞留持续减少。然而,缺乏全面的分析,包括CT评估,日本因重度哮喘而接受BT治疗的患者的临床结局。本研究旨在评估BT对日本哮喘患者的影响,重点是CT度量“WAatPi10”以评估气道疾病。
■使用ACQ6、AQLQ对12名接受BT治疗的重度持续性哮喘患者进行评估,肺功能检查,FeNO测量,采血,上叶在BT之前和第三次手术后一年的胸部CT。
■患者的中位年龄为62.0岁,7/12(58.3%)为男性,4/12(33.3%)使用常规口服皮质类固醇,8/12(66.7%)接受生物制品。FEV1%的中位数为73.6%,中位外周嗜酸性粒细胞计数为163.8/μL。BT一年后,ACQ6分数从2.4分提高到0.8分(p=0.007),AQLQ评分从4.3分提高到5.8分(p<0.001)。在哮喘发作中也观察到显着改善,由于病情恶化,计划外的访问,FeNO,和√WA在Pi10(p<0.05)。CT表现的基线粘液评分与FEV1(r=-0.688,p=0.013)和最大呼气中流速(r=-0.631,p=0.028)呈负相关,与外周血嗜酸性粒细胞计数呈正相关(r=-0.719,p=0.008)。一年后Pi10时√WA的变化与粘液评分的变化呈正相关(r=0.742,p=0.007)。
■这项研究有局限性,包括其单臂观测设计和小样本量。然而,BT导致严重哮喘患者的症状改善。CT上经过验证的“√WAatPi10”指标有效地评估了日本哮喘患者BT后的治疗反应。
UNASSIGNED: Bronchial thermoplasty (BT) improves clinical outcomes and quality of life for patients with severe asthma and has shown sustained reductions in airway narrowing and air trapping in previous CT studies. However, there is a lack of a comprehensive analysis, including CT evaluation, of clinical outcomes in Japanese patients who have undergone BT for severe asthma. This study aimed to evaluate the impact of BT in Japanese asthma patients, with a focus on the CT metric \"WA at Pi10\" to assess airway disease.
UNASSIGNED: Twelve patients with severe persistent asthma who underwent BT were assessed using ACQ6, AQLQ, pulmonary function tests, FeNO measurement, blood sampling, and chest CT before BT and one year after the third procedure for the upper lobes.
UNASSIGNED: The median age of the patient was 62.0 years, 7/12 (58.3%) were male, 4/12 (33.3%) used regular oral corticosteroids, and 8/12 (66.7%) received biologics. Median FEV1% was 73.6%, and median peripheral eosinophil count was 163.8/μL. After one year of BT, ACQ6 scores improved from 2.4 to 0.8 points (p = 0.007), and AQLQ scores improved from 4.3 to 5.8 points (p < 0.001). Significant improvements were also observed in asthma exacerbations, unscheduled visits due to exacerbations, FeNO, and √WA at Pi10 (p < 0.05). The baseline mucus score on the CT findings was negatively correlated with FEV1 (r = -0.688, p = 0.013) and with the maximum mid-expiratory flow rate (r = -0.631, p = 0.028), and positively correlated with the peripheral blood eosinophil count (r = -0.719, p = 0.008). Changes in √WA at Pi10 after one year were positively correlated with changes in the mucus score (r = 0.742, p = 0.007).
UNASSIGNED: This study has limitations, including its single-arm observational design and the small sample size. However, BT led to a symptomatic improvement in patients with severe asthma. The validated \"√WA at Pi10\" metric on CT effectively evaluated the therapeutic response in Japanese asthma patients after BT.