Yaşlı astımlılarda orta-doz flutikazon ve salmeterolün bronkokonstriksiyonun algılanmasına etkisi

Year 2005, Volume: 12 Issue: 4, 10 - 13, 16.04.2009

Aydanur Ekici , Türkan Kara Ahmet Akın Pınar Koçyiğit Ali Karlıdağ Mehmet Ekici

Abstract

SüleymanDemirel Üniversitesi
TIP FAKÜLTESİ DERGİSİ: 2005 Aralık; 12(4)



Yaşlı astımlılarda orta-doz flutikazon ve salmeterolün bronkokonstriksiyonun algılanmasına etkisi



Aydanur Ekici, Türkan Kara, Ahmet Akın,Pınar koçyiğit, Ali karlıdağ, Mehmet Ekici



Özet

Amaç: Orta-doz Flutikazon ve salmeterol tedavisinin bronkokonstriksiyonun algılanmasına etkisinin yaşlı ve genç astımlılarda değerlendirilmesi. Metot: Yirmidokuz yaşlı astımlı (•60 yaş) ve 21 genç astımlı (<60 yaş) hasta çalışmaya katıldı. Yaşlı astımlılar semptom sürelerine göre iki gruba ayrıldı (geç başlangıçlı astım< 5 yıl; erken başlangıçlı astım •5 yıl). Orta persistan astımlı 50 hasta bir yıl boyunca günde iki defa 250 ug flutikazon propionat ve 50ug salmeterol tedavisi aldı. Her hastaya başlangıçta ve bir yıl sonra histamin ile bronş provokasyon testi yapıldı. Nefes darlığı modifiye Borg skalası ile değerlendirildi. Birinci saniye zorlu vital kapasite'de (FEV1) %20'lik bir düşmenin olduğu Borg skoru Algılama skoru 20 (AS20) olarak saptandı.Sonuçlar: Geç başlangıçlı yaşlı astımlılarda başlangıç ortalama AS20 değerleri (1.21 ± 0.18) ile tedavi sonrası ortalama AS20 değerleri (1.32 ± 0.22) arasında anlamlı fark yoktu (p=0.7). Erken başlangıçlı yaşlı astımlılarda başlangıç ortalama AS20 değerleri ile (1.45 ± 0.14) tedavi sonrası ortalama AS20 değerleri (1.11 ± 0.30) arasında anlamlı fark yoktu (p=0.2). Genç astımlılarda başlangıç ortalama AS20 değerleri (2.27 ± 0.25) ile tedavi sonrası ortalama AS20 değerleri (2.07 ± 0.29) arasında anlamlı fark yoktu (p=0.3). Yaşlı astımlılarda başlangıç ortalama AS20 değerleri (1.31 ± 0.12; 2.27 ± 0.25 p=0.001) ve tedavi sonrası ortalama AS20 değerleri (1.23 0.18; 2.07 ± 0.29 p=0.01) genç astımlılardan düşüktü. Yorum:Çalışma orta doz flutikazon ve salmeterol tedavisinin yaşlı ve genç astımlılarda bronkokonstriksiyonun algılanmasını değiştirmediğini düşündürmektedir.Ancak yaşlı astımlıların başlangıçtaki ve bir yıl sonraki algılamaları genç astımlılardan daha düşük bulunmuştur.



Anahtar kelimeler: Astım, hava yolu daralması, Borg skalası,algılama, tedavi



Abstract



Effect on perception of bronchoconstriction of moderate-dose fluticason plus salmeterol in elderly asthmatics

We evaluate the effect of moderate-dose fluticasone plus salmeterol on perception of bronchoconstriction in elderly and in young asthmatics. Twenty-one young asthmatics (aged <60yrs) and 29 elderly asthmatics (•60 yrs ) were studied. The elderly asthmatics were separated into two groups according to the duration of symptoms (late-onset asthma <5 year, early-onset asthma •5 year). 50 patients with moderate asthma were assigned to a 1yr treatment with 250 ug of fluticason propionate plus 50ug salmetorol, twice daily.At entry and after 1 yr , histamine challenge test was performed for each patient. Dyspnea was assessed by modified Borg scale. The Borg score in FEV1 reduction by 20% was determined as perception score 20 (PS20). Results: There was no significant difference between mean PS20 values at entry (1.21 ± 0.18) and after the first year(1.32 ± 0.22) for late onset elderly asthmatics (p=0.7). There was no significant difference between mean PS20 values at entry (1.45 ± 0.14) and after the first year (1.11 ± 0.30) for early onset elderly asthmatics (p=0.2). There was no difference between mean PS20 values at entry (2.27 ± 0.25) and after the first year (2.07 ± 0.29) for young asthmatics (p=0.3). The mean PS20 value of elderly asthmatics at entry (1.31 ± 0.12, 2.27 ± 0.25 p=0001) and after the first year (1.23 ± 0.18, 2.07 ± 0.29 p=0.01) was lower than young asthmatics. Conclusion: Our study suggested that the treatment of moderate-dose fluticasone plus salmeterol did not change perception of bronchoconstriction in elderly asthmatics. Perception of elderly asthmatics at entry and after 1 yr was lower than young asthmatics.



Key words: asthma, bronchoconstriction, Borg scale, perception, treatment

Keywords

Astým, hava yolu daralmasý, Borg skalasý, algýlama, tedavi

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