老年支气管哮喘临床和超敏反应的特征  

The clinical and allergic characteristics of asthma in the elderly persons

作　　者：朱本洪[1] 杨天芸[1] 沈铮[1] 黎明[1] 

机构地区：[1]上海第二医科大学新华医院呼吸内科,200092

出　　处：《实用老年医学》1999年第5期252-254,共3页Practical Geriatrics

摘　　要：目的　探讨老年支气管哮喘临床和超敏反应的特征　方法　３０ 例老年组与４５ 例青年组支气管哮喘患者相比较，其临床特征和超敏反应测试指标。　结果　老年组支气管哮喘起病年龄多在４０ 岁以后、病程大于１５ 年，冬季发病，全年发作，吸烟史、呼吸道感染和油烟诱因、脓痰、肺部呼吸音强度降低、呼气相延长和干湿性啰音体征、肺功能ＦＥＶ１ ％ 显著降低较多见。患者常伴有慢性支气管炎、肺气肿、肺心病、肺部感染、高血压、冠心病和糖尿病等疾病。而春秋季发作、吸入诱因、家族过敏史、Ｐｈａｒｍａｃｉａ 变应原阳性者和ＥＣＰ 值升高较少见，与青年组相比有显著差异（ Ｐ＜ ０－０５） 。感冒、本人过敏史、过敏性鼻炎和ＩｇＥ 值升高，２ 组之间无显著差异。　结论　虽老年支气管哮喘有其特有的临床表现和超敏反应特征，但超敏反应是重要而又不是唯一的发病机制；然而超敏反应病的体外诊断仍有其临床意义，但主要依靠病史、症状和体征综合诊断；因并发慢性阻塞性肺部疾病和肺部感染，易漏诊和误诊及治疗不当。To explore the clinical and allergic characteristics of asthma in elderly persons. Methods Take 30 samples of elderly asthma patients and 45 samples of young asthma patients;Compare the clinical characteristics and allergic test indices of elderly asthma patients with those of the young asthma patients. Results Among the elderly asthma patients,most develop asthma after the age of 40 and have a duration of illness of more than 15 years and a history of smoking.Attacks happen to them during the whole year and more often in winter.Most of them have respiratory infection,inducing factor of oil and smoking,puric sputum,decreased intensity of breathing sound in chest,prolonged expiratory phase,rales and remarkably decreased FEV 1%.Chronic bronchitis,pulmonary emphysema,cor pulmonale,pulmonary infection,hypertension,coronary heart disease and diabetes are more common among them ( P <0 05).On the other hand attacks happening in spring and fall,inducing factors of inspiratory atopen,familial allergic history,posivtie pharmarcia atopen patients,and increased ECP level occur less frequently among them ( P <0 05).This makes them significantly different from young asthma patients.However,there is no obvious difference between two groups in cold,self of allergic history,allergic rhinitis and increased IgE level. Conclusions Asthma in elderly patients have its unique clinical and allergic characteristics;Allergy is an important but not the only pathogenic mechanism;Though allergic experimental diagnosis still has clincal significance,more importance should be given to comprehensive diagnosis through the observation of history of disease,sign,and symptoms.It is likely for doctors to miss diagnosis,give inaccurate diagnosis and provide improper treatment because of the complexion of chron

关 键 词：支气管哮喘 超敏反应 肺功能 老年人 

分 类 号：R562.25[医药卫生—呼吸系统]