TY - JOUR T1 -长期坚持吸入糖皮质激素是否预测哮喘相关预后?一个队列研究摩根富林明-欧洲呼吸杂志》乔和J - 10.1183/13993003.00901 -2019欧元六世- 54 - 6 SP - 1900901 AU -迪玛,亚历山德拉•l . AU - van Ganse Eric AU - Stadler Gertraud AU - de熊先生,Marijn A2 -,Y1 - 2019/12/01 UR - //www.qdcxjkg.com/content/54/6/1900901.abstract N2 -吸入糖皮质激素(ICS)的依从性对哮喘管理很重要。目前关于ICS依从性对结果影响的证据大多基于人与人之间数据的相关性分析。尽管人们普遍认为哮喘的结果会随着时间的推移而波动，但关于人体内变化的预测因子的证据很少。我们的目的是量化这些波动和ICS依从性与个人水平和个人水平的结果之间的纵向关系。在法国和英国的一项持续哮喘患者前瞻性队列研究(n=847，年龄6 - 40岁)通过计算机辅助电话采访和短信提供了3756份关于ICS依从性、哮喘控制、缓解药物使用和加重的报告，时间长达2年。我们通过纵向模型检验了坚持-结果关系，控制了混杂因素，包括严重程度。在加重(91%)、哮喘控制(59%)和缓解剂使用(52%)中发现了相当大的个体差异;431份(11.5%)报告显示病情恶化，2046份(54.5%)报告显示病情控制不良。 At between-person level, patients with higher average adherence were more likely to report asthma control (OR 1.25, 95% CI 1.06−1.47), but not asthma exacerbations (OR 0.99, 95% CI 0.87−1.12) or lower reliever use (b −0.0004, 95% CI −0.089−0.088). At within-person level, higher-than-usual adherence was associated with higher concomitant reliever use (b 0.092, 95% CI 0.053−0.131) and lower subsequent reliever use (b −0.047, 95% CI −0.005− −0.088); it was unrelated to asthma control (OR 0.93, 95% CI 0.84−1.02) or exacerbations (OR 1.04, 95% CI 0.94−1.16).Patients maintaining high ICS adherence over time have better asthma control. Temporarily increasing ICS adherence tends to be simultaneous to higher reliever use and reduces reliever use later on. Causes of within-person variation in outcomes require more investigation.Cohort study in routine care finds large variability in asthma outcomes over time. Patients with higher mean ICS adherence report better asthma control. ICS adherence and reliever use tend to increase at the same time and reduce use of relievers later on. http://bit.ly/2kK1bbv ER -