Churg-Strauss综合征患者的哮喘病程
2011/03/28
摘要
目的：哮喘是Churg-Strauss 综合征(CSS)的一个主要表现，但CSS患者中的哮喘病程尚未清楚。本研究旨在CSS患者中分析哮喘病程。
患者与方法：本试验为回顾性研究，22名CSS患者入选。对病历进行研究，并询问患者在随访期间的哮喘症状，共4次，包括CSS诊断时、出院时的指导及首次和最后一次评价临床和实验室CSS缓解时。随访时检测肺功能。哮喘控制与严重程度评价与当前指南一致。
结果：哮喘组，21名患者为成人期发作的哮喘，平均发作年龄为35.5±11.8 岁，初期表现为鼻窦炎（100%）和鼻息肉（36%）。初始发作时，严重哮喘占68.5%，中度哮喘占27%，而且这21名患者的哮喘控制极差。64%的患者存在过敏症。血管炎症状的发作和CSS诊断时，存在血液嗜酸性粒细胞增多（最大为7.2 x 103/l [1.2 - 32]），16名患者因气道梗阻导致哮喘恶化（FEV1和FVC平均值分别为68.8±17.5%和84.8±19.6%），且存在肺部受损。治疗后和获得疾病稳定缓解后，哮喘严重程度和肺功能得到显著改善（FEV1为92.7±13.3%，FVC为101±15.5%）（P< .001）。
结论：CSS患者的哮喘在发作初期较为严重，在CSS缓解后哮喘也得到很大程度改善。
（苏楠 审校）
J Asthma. 2011 Jan 20. [Epub ahead of print]
The Course of Asthma in Churg-Strauss Syndrome.
Szczeklik W, Magdalena Sokołowska B, Zuk J, Mastalerz L, Szczeklik A, Musiał J.
Department of Medicine, Jagiellonian University Medical College, Skawinska, Krakow, Poland.
Abstract
Objectives. Asthma is one of the key features of Churg-Strauss syndrome (CSS); however its course in the disease is unclear. The aim of this study was to analyze the asthma course in CSS patients.
Patients and methods. We conducted a retrospective study of 22 CSS patients. Medical documentation was studied and patients were questioned about asthma symptoms during follow-up visits, which took place at four points of the disease. These points, at which lung function tests were performed, were CSS diagnosis; introduction of treatment at hospital discharge; and assessment of the first and last clinical and laboratory CSS remissions. Asthma control and severity were assessed in compliance with current guidelines.
Results. In the asthmatic group examined, 21 patients had an adult-onset asthma, with a mean age of onset 35.5 ± 11.8 years, preceded by sinusitis (100%) and nasal polyposis (36%). Asthma at its onset was severe in 68.5%, moderate in 27%, and very poorly controlled in 21 patients. Atopy was present in 64% of patients. Onset of vasculitic symptoms and CSS diagnosis was accompanied by high blood eosinophilia (maximal 7.2 x 10(3)/l [1.2 - 32], asthma exacerbation with airway obstruction in 16 patients (mean values of FEV1 68.8±17.5% and FVC 84.8±19.6%), and lung involvement. After introducing the treatment and achieving stable remission, asthma severity/control and lung function tests (forced expiratory volume in 1 s 92.7 ± 13.3%, and forced vital capacity 101 ± 15.5%; p < .001) improved. Conclusions. Asthma in CSS, although severe as its onset improves after achieving CSS remission.
J Asthma. 2011 Jan 20. [Epub ahead of print]
目的：哮喘是Churg-Strauss 综合征(CSS)的一个主要表现，但CSS患者中的哮喘病程尚未清楚。本研究旨在CSS患者中分析哮喘病程。
患者与方法：本试验为回顾性研究，22名CSS患者入选。对病历进行研究，并询问患者在随访期间的哮喘症状，共4次，包括CSS诊断时、出院时的指导及首次和最后一次评价临床和实验室CSS缓解时。随访时检测肺功能。哮喘控制与严重程度评价与当前指南一致。
结果：哮喘组，21名患者为成人期发作的哮喘，平均发作年龄为35.5±11.8 岁，初期表现为鼻窦炎（100%）和鼻息肉（36%）。初始发作时，严重哮喘占68.5%，中度哮喘占27%，而且这21名患者的哮喘控制极差。64%的患者存在过敏症。血管炎症状的发作和CSS诊断时，存在血液嗜酸性粒细胞增多（最大为7.2 x 103/l [1.2 - 32]），16名患者因气道梗阻导致哮喘恶化（FEV1和FVC平均值分别为68.8±17.5%和84.8±19.6%），且存在肺部受损。治疗后和获得疾病稳定缓解后，哮喘严重程度和肺功能得到显著改善（FEV1为92.7±13.3%，FVC为101±15.5%）（P< .001）。
结论：CSS患者的哮喘在发作初期较为严重，在CSS缓解后哮喘也得到很大程度改善。
（苏楠 审校）
J Asthma. 2011 Jan 20. [Epub ahead of print]
The Course of Asthma in Churg-Strauss Syndrome.
Szczeklik W, Magdalena Sokołowska B, Zuk J, Mastalerz L, Szczeklik A, Musiał J.
Department of Medicine, Jagiellonian University Medical College, Skawinska, Krakow, Poland.
Abstract
Objectives. Asthma is one of the key features of Churg-Strauss syndrome (CSS); however its course in the disease is unclear. The aim of this study was to analyze the asthma course in CSS patients.
Patients and methods. We conducted a retrospective study of 22 CSS patients. Medical documentation was studied and patients were questioned about asthma symptoms during follow-up visits, which took place at four points of the disease. These points, at which lung function tests were performed, were CSS diagnosis; introduction of treatment at hospital discharge; and assessment of the first and last clinical and laboratory CSS remissions. Asthma control and severity were assessed in compliance with current guidelines.
Results. In the asthmatic group examined, 21 patients had an adult-onset asthma, with a mean age of onset 35.5 ± 11.8 years, preceded by sinusitis (100%) and nasal polyposis (36%). Asthma at its onset was severe in 68.5%, moderate in 27%, and very poorly controlled in 21 patients. Atopy was present in 64% of patients. Onset of vasculitic symptoms and CSS diagnosis was accompanied by high blood eosinophilia (maximal 7.2 x 10(3)/l [1.2 - 32], asthma exacerbation with airway obstruction in 16 patients (mean values of FEV1 68.8±17.5% and FVC 84.8±19.6%), and lung involvement. After introducing the treatment and achieving stable remission, asthma severity/control and lung function tests (forced expiratory volume in 1 s 92.7 ± 13.3%, and forced vital capacity 101 ± 15.5%; p < .001) improved. Conclusions. Asthma in CSS, although severe as its onset improves after achieving CSS remission.
J Asthma. 2011 Jan 20. [Epub ahead of print]
上一篇：
伴过敏性鼻炎的轻度哮喘患者，鼻内皮质激素治疗对哮喘控制和生活质量的影响
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5A,一种载脂蛋白A-I模拟肽, 能抑制屋尘螨诱导的哮喘
