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Yaşlı astımlılarda orta-doz flutikazon ve salmeterolün bronkokonstriksiyonun algılanmasına etkisi

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

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Abstract (2. Language): 
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 PEV1 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: Öur 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.
Abstract (Original Language): 
Amaç: Örta-doz plutikazon ve salmeterol tedavisinin bronkokonstriksiyonun algýlanmasýna etkisinin yaþlý ve genç astýmlýlarda deðerlendirilmesi. Metot: Yirmidokuz yaþlý astýmlý (>60 yaþ) ve 21 genç astýmlý (<60 yaþ) hasta çalýþmaya katýldý. Yaþlý astýmlýlar semptom sürelerine göre iki gruba ayrýldý (geç baþlangýçlý astým< 5 yýl; erken baþlangýçlý astým>5 yýl). Örta persistan astýmlý 50 hasta bir yýl boyunca günde iki defa 250 ug flutikazon propionat ve 50ug salmeterol tedavisi aldý. Her hastaya baþlangýçta ve bir yýl sonra histamin ile bronþ provokasyon testi yapýldý. Nefes darlýðý modifiye Borg skalasý ile deðerlendirildi. Birinci saniye zorlu vital kapasite'de (pEV1) %20'lik bir düþmenin olduðu Borg skoru Algýlama skoru 20 (AS20) olarak saptandý.Sonuçlar: Geç baþlangýçlý yaþlý astýmlýlarda baþlangýç ortalama AS20 deðerleri (1.21 ± 0.18) ile tedavi sonrasý ortalama AS20 deðerleri (1.32 ± 0.22) arasýnda anlamlý fark yoktu (p=0.7). Erken baþlangýçlý yaþlý astýmlýlarda baþlangýç ortalama AS20 deðerleri ile (1.45 ± 0.14) tedavi sonrasý ortalama AS20 deðerleri (1.11 ± 0.30) arasýnda anlamlý fark yoktu (p=0.2). Genç astýmlýlarda baþlangýç ortalama AS20 deðerleri (2.27 ± 0.25) ile tedavi sonrasý ortalama AS20 deðerleri (2.07 ± 0.29) arasýnda anlamlý fark yoktu (p=0.3). Yaþlý astýmlýlarda baþlangýç ortalama AS20 deðerleri (1.31 ± 0.12; 2.27 ± 0.25 p=0.001) ve tedavi sonrasý ortalama AS20 deðerleri (1.23 0.18; 2.07 ± 0.29 p=0.01) genç astýmlýlardan düþüktü. Yorum:Çalýþma orta doz flutikazon ve salmeterol tedavisinin yaþlý ve genç astýmlýlarda bronkokonstriksiyonun algýlanmasýný deðiþtirmediðini düþündürmektedir.Ancak yaþlý astýmlýlarýn baþlangýçtaki ve bir yýl sonraki algýlamalarý genç astýmlýlardan daha düþük bulunmuþtur.
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