Gani Federica, Frezet Massimo Mosca, Senna Gianenrico, Passalacqua Gianni, Lombardi Carlo
Recenti Prog Med. 2003 Jul-Aug;94(7-8):324-9.
Over the last few years, the importance of sport in everyday life has rapidly increased. Asthma and allergic rhinitis are among the most common problems to be afforded in those practising sports. It is believed that allergy represents a limitation to sport activity, but many elite athletes suffer from respiratory allergy: within those participating in the Olympic Games, 49% suffered from allergic rhinitis, and 20% of winter sport athletes suffered from asthma. Exercise is a potent trigger factor for asthma both in allergic and non allergic subjects. About 70% of asthmatic patients experience asthma symptoms during exercise; skiing and running in particular can elicit bronchospasm. Swimming is usually considered a non asthmogenic sport, but the inhalation of chloride derivatives and irritants can favor asthma onset. From a pathogenic point of view, exercise induced asthma seems to be due to sudden changes of osmolarity in the mucus layer on bronchial walls induced by hyperventilation and low temperature of inspired air. Athletes also suffer from non allergic rhinitis that can influence their performance. Rhinitis in fact modify the correct ventilation and can induce lower respiratory disorders, like asthma. Recently, cold-induced rhinitis has been described in those athletes practicing winter sports, especially skiers. This rhinitis is characterized mainly by rhinorrhea, and responds to topical anti-cholinergic agents. In conclusion, sport can exacerbate or induce asthma and rhinitis but this fact does not represent a limitation to physical activity. A deep knowledge of the diseases occurring during exercise, a detailed education and a correct therapy, allow to perform sports even at high levels also in presence of respiratory allergy.
在过去几年中,运动在日常生活中的重要性迅速提升。哮喘和过敏性鼻炎是从事体育运动的人群中最常见的问题。人们认为过敏是体育活动的一种限制,但许多精英运动员患有呼吸道过敏:在参加奥运会的运动员中,49%患有过敏性鼻炎,20%的冬季项目运动员患有哮喘。运动是过敏性和非过敏性人群哮喘的一个强效触发因素。约70%的哮喘患者在运动时会出现哮喘症状;特别是滑雪和跑步会引发支气管痉挛。游泳通常被认为是一种不易引发哮喘的运动,但吸入氯化物衍生物和刺激性物质会促使哮喘发作。从发病机制的角度来看,运动诱发的哮喘似乎是由于过度通气和吸入空气低温导致支气管壁黏液层渗透压突然变化所致。运动员还会患非过敏性鼻炎,这可能会影响他们的表现。事实上,鼻炎会改变正常的通气功能,并可能引发诸如哮喘等下呼吸道疾病。最近,在从事冬季运动的运动员,尤其是滑雪运动员中发现了冷诱导性鼻炎。这种鼻炎主要表现为流鼻涕,对局部抗胆碱能药物有反应。总之,运动可能会加重或诱发哮喘和鼻炎,但这一事实并不意味着要限制体育活动。深入了解运动过程中出现的疾病、进行详细的教育并采取正确的治疗方法,即使在存在呼吸道过敏的情况下,也能高水平地进行体育运动。