Risk factors related to fixed airway obstruction in patients with asthma after antiasthma treatment.

摘要

BACKGROUND: There are many unanswered questions about the role of airway remodeling in asthma. OBJECTIVE: To evaluate the physiologic factors related to airway remodeling after antiasthma drug treatment for 1 year. METHODS: We gave 582 patients with asthma long-term control medication for 1 year according to the severity of their asthma. Airway remodeling was defined using forced expiratory volume in 1 second/forced vital capacity and a predicted forced expiratory volume in 1 second of less than 75% after antiasthma treatment. RESULTS: Of the 582 patients, 49 (8.4%) had airway remodeling. Severe asthma resulted in more airway remodeling than mild-to-moderate asthma. Asthmatic patients with airway remodeling were significantly older and had a longer duration of asthma. Asthmatic patients with airway remodeling had more emphysema on high-resolution computed tomography, a higher rate of near-fatal asthma attacks, a lower percentage of sputum eosinophils, a lower atopy frequency, a greater response to short-acting bronchodilators, and a lower body mass index (BMI) than those without airway remodeling. Age, asthma duration, and BMI were important discriminators of airway remodeling. CONCLUSION: Nonatopy, asthma duration, emphysema on high-resolution computed tomography, sputum eosinophils, age, and BMI before antiasthma treatment are important factors related to airway remodeling in patients with asthma.