TY - JOUR T1 -哮喘药物在肥胖和健康体重哮喘中的应用:JF - European Respiratory Journal JO - Eur Respir J DO - 10.1188 /13993003.00612-2020 VL - 57 IS - 3 SP - 2000612 AU - Thompson, Cherry A. AU - Eslick, Shaun R. AU - Berthon, Bronwyn S. AU - Wood，肥胖是一种常见的哮喘共病，与较差的哮喘控制、更频繁/更严重的发作和哮喘药物治疗的反应降低有关。本综述旨在比较肥胖(体重指数(BMI)≤30 kg·m−2)和健康体重(BMI <25 kg·m−2)哮喘受试者中所有类别哮喘药物的使用情况。研究人员搜索了截至2019年7月的包括CINAHL(护理和联合健康文献累积索引)、Cochrane、Embase和MEDLINE在内的设计数据库，检索了记录了肥胖和健康体重成人哮喘患者药物使用或剂量的英语研究。一个批判性的评估清单被用来仔细检查合格研究的方法学质量。进行meta分析，采用卡方检验检验异质性。本综述基于已发表的协议(www.crd.york.ac.uk/PROSPERO CRD42020148671)进行。meta分析显示，肥胖受试者更可能使用包括短效β2激动剂在内的哮喘药物(OR 1.75, 95% CI 1.17-2.60;p=0.006, I2=41%)和维持口服糖皮质激素(OR 1.86, 95% CI 1.49-2.31;p<0.001, I2=0%)。 Inhaled corticosteroid (ICS) dose (µg·day−1) was significantly higher in obese subjects (mean difference 208.14, 95% CI 107.01–309.27; p<0.001, I2=74%). Forced expiratory volume in 1 s (FEV1) % predicted was significantly lower in obese subjects (mean difference −5.32%, 95% CI −6.75–−3.89; p<0.001, I2=42%); however, no significant differences were observed in FEV1/forced vital capacity (FVC) ratio between groups.Conclusions We found that obese subjects with asthma have higher use of all included asthma medication classes and higher ICS doses than healthy-weight asthma subjects, despite lower FEV1 and a similar FEV1/FVC %. A better understanding of the factors driving increased medication use is required to improve outcomes in this subgroup of asthmatics.Obese asthmatics have higher use of all included asthma medications and take higher ICS doses than healthy-weight subjects, despite similar FEV1/FVC %, emphasising the need for new, more effective management strategies to be developed for this population. https://bit.ly/2EQtPSi ER -