抽象
还有的支气管哮喘患者谁是在接受阿司匹林和其他非类固醇抗炎药易患疾病加重的一个子集。这是一种临床综合征,称为阿司匹林诱发的哮喘(AIA),在花生四烯酸代谢和半胱氨酰白三烯过量产生改变相关。自然史和这种类型哮喘的临床特征进行了研究。在10个欧洲国家的16个临床中心提供的标准化信息有关专门开发面向患者的数据库:病史,体格检查,诊断和治疗。AIA的诊断是基于典型的历史,通过积极的阿司匹林激发试验,在对91%的患者进行了证实。共有500例患者被纳入研究。AIA根据图案显影,其特征在于,症状的序列。首先,持续性鼻炎,出现在29.7 +/- 12.5岁,则哮喘平均年龄,阿司匹林不容忍和鼻息肉出现。在欧洲不同国家的临床表现是惊人的相似。女性,谁2.3寡不敌众男性:1,发病症状显著发生较早和疾病是更进步,更比男性严重。 Atopy, present in approximately a third of patients, led to earlier manifestation of rhinitis and asthma, but not of aspirin intolerance or nasal polyposis. A family history of aspirin intolerance, recorded in 6% of patients, had a less evident effect on the course of the disease than sex or atopy. Fifty one per cent of patients, in addition to inhaled steroids, required chronic systemic corticosteroid therapy at a mean dose of 8 mg prednisone x day(-1). Surprisingly, 15% of patients were unaware of intolerance to aspirin and learnt about it only after having provocation tests performed. All over Europe, aspirin-induced asthma develops in a similar characteristic way. Its course is influenced by sex and the presence of atopy. In half of the patients, asthma is severe, and steroid-dependent. The uniform natural history of aspirin-induced asthma might suggest a common underlying principle.