高原地区速发型哮喘发作特点及吸入大剂量β激动剂治疗的研究  

Characteristics and response to inhaling β2-agonist for rapid-onset asthma attack at high altitude

作　　者：杨生岳[1] 冯恩志[1] 张瑛[1] 董红梅[1] 高玲[1] 

机构地区：[1]解放军第四医院兰州军区呼吸内科中心,青海西宁810014

出　　处：《西北国防医学杂志》2002年第3期180-182,共3页Medical Journal of National Defending Forces in Northwest China

摘　　要：目的 :探讨高原地区速发型哮喘发作 (ROAA)和迟发型哮喘发作 (SOAA)在成人急性重症哮喘患者中各占的比例、两者的临床和肺功能是否存在差异以及对β激动剂的治疗反应。 方法 :对ROAA (16例 )和SOAA(76例 )患者 ,采用经定量型雾化吸入器 (MDI)和贮雾瓶吸入沙丁胺醇治疗 ,每隔 10min 30 0 μg,共持续 3h。在给药前、后 30、6 0、90、180min即刻检查肺功能、辅助呼吸肌活动、并观察呼吸困难和哮鸣音变化。后 3项依据严重程度计分 ,平均值为临床指数。结果 :ROAA发生率和上呼吸道感染诱发者 (分别为 17.4%、12 .5 % )显著低于SOAA(分别为 82 .6 %、43.4% ) ,P均 <0 .0 1;ROAA组FEV1占预计值 %和PEF占预计值 %降低较SOAA组更显著 (P均 <0 .0 5 )。给药后 30、6 0、90、180minROAA组和SOAA组FEV1占预计值 %、PEF占预计值 %较给药前均显著升高 (P均 <0 .0 1) ;临床指数均显著降低 (P均 <0 .0 1)。给药后 6 0、90、180minROAA组三项指标改善较SOAA组更显著 (P <0 .0 1或 <0 .0 5 )。结论 :高原地区ROAA是一组少见的哮喘急性发作 ,病情发展快。经MDI和贮雾瓶吸入大剂量沙丁胺醇是治疗高原急性哮喘的有效方法 ,与SOAA比较 。Objective:To study the freqrency and difference between rapid-onset asthma attack(ROAA) and slow-onset asthma attack(SOAA) in adult patients and response to therapy in inhaling β2-agonist at high altitude.Methods:16 patients with ROAA and 76 patients with SOAA inhaled albuterol,300 μg at 10 min interval,delivered by a metered-dose inhaler and a spacer device during 3 h.Activity scores of accessory respiratory muscles,dysnea,wheezing(clinical index) and lung function were observed at 0,30,60,90,180 min.Results:16 patients were classified ROAA(17.4% vs 82.6% for SOAA patients,P<0.01) and was less likely to be attributed to respiratory tract infection( 12.5% vs 43.4% for SOAA patients,P<0.01).Also,ROAA patients had lower lung function than those in SOAA patients.At 30,60,90,180 min after therapy, FEV 1% predicted ,PEF% predicted and clinical index in both groups were markedly improved(all P<0.01),and ROAA group were markedly better than those in SOAA group(P<0.01 or P<0.05).Conclusion:ROAA constitute a distinct acute asthma presentation and ROAA patients have a more rapid response to treatment with inhaling β2-agonist than SOAA patients.

关 键 词：哮喘 速发型 β激动剂 高原 

分 类 号：R562.25[医药卫生—呼吸系统]