Influencing factors for efficacy of triple therapy in patients with poor asthma control
Objective To explore the influencing factors for efficacy of triple therapy in patients with poor asthma control.Methods A total of 260 patients with poor asthma control were selected,and they all received triple therapy(budesonide+formoterol+tiotropium bromide)for treatment.After 1 year of treatment,patients were assigned to effective group(n=196)or ineffective group(n=64)according to efficacy.General data,pulmonary function indices with respect to forced expiratory volume in first second(FEV1),forced vital capacity(FVC),CO diffusion capacity-single breath method(DLCO-sb),maximal voluntary ventilation(MVV),FEV1/FVC％,FVC％,and FEV1％＜80％proportion,fractional exhaled nitric oxide(FeNO),respiratory muscle function indices in terms of PaO2,PaCO2,SaO2,maximal inspiratory pressure,maximal expiratory pressure(MEP),exercise capacity indices(6-minute maximal walking distance,maximal oxygen uptake),dyspnea degree with respect to British Medical Research Council(MRC)score,baseline dyspnea index(BDI),and nutrition states(serum prealbumin,albumin,hemoglobin)were compared between patients of the two groups.The influencing factors for efficacy of triple therapy in patients with poor asthma control were analyzed by using the multivariate Logistic regression model,and the predictive value of the influencing factors for its efficacy was evaluated by drawing the receiver operating characteristic curve.Results The effective group exhibited lower proportions of smoking history,family history of asthma,history of allergic rhinitis,and severe disease condition as compared with the ineffective group(P＜0.05).The effective group yielded higher MVV,FVC％,and MEP,whereas lower FeNO,MRC score,BDI,and a lower FEV1％＜80％proportion as compared with the ineffective group(P＜0.05).The results of multivariate Logistic regression analysis revealed that FVC％,FeNO,FEV1％＜80％,BDI,and MRC score were the influencing factors for efficacy of triple therapy in patients with poor asthma control(P＜0.05).Area under the curve of 5 aforementioned indices for jointly predicting efficacy of triple therapy in patients with poor asthma control was larger than that of single prediction of the 5 indices(P＜0.05).Conclusion FVC％,FeNO,FEV1％＜80％,BDI,and MRC score are the influencing factors for efficacy of triple therapy in patients with poor asthma control.All these 5 aforementioned indices exert efficiency for predicting efficacy to a certain extent,and the combined prediction efficiency is superior.
万方数据
维普
