Zimmerman J L, Woodruff P G, Clark S, Camargo C A
Department of Internal Medicine, Ben Taub General Hospital, Baylor College of Medicine, Houston, Texas, USA.
Am J Respir Crit Care Med. 2000 Aug;162(2 Pt 1):512-5. doi: 10.1164/ajrccm.162.2.9910105.
Hormonal fluctuations during the menstrual cycle are hypothesized to influence the course of asthma among women. A recent study found that almost 50% of emergency department (ED) visits occur during the perimenstrual phase. Our prospective cohort study in 64 EDs examined the relation between phase of menstrual cycle and visits for acute asthma. A total of 288 women with acute asthma were evaluated with a standardized patient interview and medical record review after excluding subjects who were pregnant, on hormonal therapy, postmenopausal, status post hysterectomy, had incomplete reproductive data, or whose ED visit fell more than 28 d after their last menstrual period. Only 13% reported reproductive factors as a personal asthma trigger. For all subjects, ED asthma visits were classified by menstrual phase: 33% were preovulatory (Days 5 to 11), 26% were periovulatory (Days 12 to 18), 20% were postovulatory (Days 19 to 25), and 21% were perimenstrual (Days 26 to 4), p = 0.008. There was no significant association between phase of menstrual cycle and asthma severity. Our data indicate that ED visits for acute asthma among women are more frequent during the preovulatory phase in contrast to other studies reporting more visits in the perimenstrual phase.
月经周期中的激素波动被认为会影响女性哮喘的病程。最近一项研究发现，近50%的急诊就诊发生在围经期。我们在64个急诊科开展的前瞻性队列研究，考察了月经周期阶段与急性哮喘就诊之间的关系。在排除了怀孕、接受激素治疗、绝经后、子宫切除术后、生殖数据不完整或急诊就诊距离末次月经超过28天的受试者后，共有288名急性哮喘女性接受了标准化的患者访谈和病历审查。只有13%的人报告生殖因素是个人哮喘的触发因素。对于所有受试者，急诊哮喘就诊按月经阶段分类：33%为排卵前（第5至11天），26%为围排卵期（第12至18天），20%为排卵后（第19至25天），21%为围经期（第26至4天），p = 0.008。月经周期阶段与哮喘严重程度之间无显著关联。我们的数据表明，与其他报道围经期就诊较多的研究相比，女性急性哮喘的急诊就诊在排卵前阶段更为频繁。
