【摘要】 目的 探讨预防呼吸道病毒感染诱导哮喘发作方法的有效性和安全性。方法 86例哮喘缓解期患者随机分为对照组(A组，29例)和试验组(B组，57例)，每位患者出现急性上感症状后3天即病毒感染诱导哮喘发作窗内来诊，A组在哮喘发作前不予任何干预措施。B组于就诊当天即予大剂量的吸入性糖皮质激素和抗胆碱能药物，用药3～7天。两组哮喘发作按常规处理，随访观察7～14天。就诊当天行血常规、胸片、血气分析和肺功能测定，对出现哮喘症状的患者复查血气分析和肺功能测定。结果 两组各失访1例，B组出现声音嘶哑1例。A组最终随访观察患者总数为28例，哮喘不同程度发作共有16例，比例为57.1%,其中轻度发作6例，中度发作7例，重度发作3例。B组最终随访观察患者总数为55例，哮喘不同程度发作共有18例，比例为32.7%，其中轻度发作10例，中度发作8例，无重度发作。A、B两组哮喘发作情况差异有显著性(P<0.05)。结论 在病毒感染诱导哮喘发作窗内给予大剂量吸入性糖皮质激素及抗胆碱能药物可有效而安全地避免相当多的哮喘患者发作及降低哮喘发作的程度和肺功能的损害,进而减少住院率和费用。

    【关键词】 上呼吸道病毒感染;哮喘;急性发作；预防

    Clinical prevention of respiratory tract viral infection-induced asthma attacks

    ZHANG You-zhi, CHEN Xiao-dong,ZHANG Jing,et al.

    Shidong Hospital of Yangpu District,Shanghai 200040,China

    【Abstract】 Objective To investigate the efficacy and safety of prevention for respiratory tract viral infection induced asthma attacks.Methods 86 subjects with respiratory tract viral infection were randomly divided into control group (group A,29) and experiment group(group B,57).No measure was provided for group A before asthma attacks ,but routine measure after asthma attacks;A large dosage of ICS and anticholinergic bronchodilators were given for group B in the 3 days after asthma attacks. All the patients were given blood routine test,chest X-ray and lung function test at the hospitalization day. All the patients were followed for 7～14 days with recording common cold and asthma symptoms.Results A case was lost in every group and a patient was hoarse in grouop B. Asthma attacks rate was 57.1% in group A: mild asthma attacks were in 6 patients,moderate in 7,and severe in 3. Asthma attacks rate was 32.7% in group B: mild asthma attacks were in 10 patients and moderate in 8. Asthma attacks in group B were decreased significantly when compared with group A(P<0.05).Conclusions A large amounts of asthma patients will be avoided to exacerbate if a large dosage ICS and anticholinergic drugs provided for them,which will decrease the grade of asthma attacks and decrease of lung function,consequently hospitalization rate and charge were reduced. ......