TY - JOUR T1 -大剂量吸入类固醇治疗哮喘受试者皮肤瘀伤:频率和与肾上腺功能JF -欧洲呼吸杂志》乔和J SP - 226 LP - 231欧元六世- 9 - 2非盟-罗伊,非盟——勒布朗,C AU -帕克特,L盟——Ghezzo H盟——象牙海岸,J盟——卡地亚,非盟的目的,N2 -大剂量吸入皮质类固醇(ICS)(布地奈德和倍氯米松>或= 800微克。天-1)通常用于治疗哮喘。一些研究人员提出了皮肤效应(挫伤)的证据，提示全身吸收。本研究旨在评估皮肤挫伤的患病率，将皮肤挫伤的发生与肾上腺皮质功能联系起来，并确定皮肤挫伤的危险因素。在哮喘门诊招募100名成年哮喘受试者，服用高剂量(800- 2000微克。天-1)3个月或更长时间的ICS，并从眼科门诊招募100名性别和年龄配对的对照受试者。对哮喘、一般习惯和皮肤损害进行了详细的问卷调查。进行皮肤检查。连续两天评估尿液皮质醇水平。 Blood cortisol level and the response to Cortrosyn injection (60 min test) were evaluated. One hundred adult asthmatics (66 females and 34 males), 73 on beclomethasone and 27 on budesonide, were included. The prevalence of skin bruising was 71% based on the questionnaire (32% in controls) and 48% (39 out of 81 subjects) based on direct examination of the skin. We found a satisfactory association between the response to questionnaire and examination of the skin. Adrenocortical function testing showed that a minority of subjects (14 with at least one abnormal test) had lower urinary or blood cortisol levels. These low cortisol levels occurred in subjects who reported skin bruising. By multiple logistic regression, being a female (odds ratio (OR) = 20; 95% confidence interval (95% CI) = 13-33) and taking ICS for asthma (OR = 12; 95% CI = 8-18) were significantly (t = 5.4) related to the likelihood of developing skin bruising. In addition, among the asthmatic subjects, being older (OR = 1.6; 95% CI = 1.1-2.4/10 yrs interval) (t = 2.3) and being a female (OR = 22; 95% CI = 7-75) (t = 5.0) influenced the occurrence of skin bruising as documented by questionnaire. In asthmatic subjects, taking high doses of ICS is associated with: 1) increased occurrence of skin bruising by comparison with controls, particularly in older subjects; and 2) a generally normal adrenocortical function, although this function is significantly lower in subjects reporting skin bruising. ER -