Ameille Jacques, Descatha Alexis
Department of Occupational Health, Raymond Poincaré Hospital, ap-hp, Garches, France.
Curr Opin Allergy Clin Immunol. 2005 Apr;5(2):125-8. doi: 10.1097/01.all.0000162303.59363.b4.
Occupational asthma is often associated with serious work and financial consequences. Correct management of occupational asthma must be based on a good knowledge of the natural history of the disease and of its prognostic factors.
Longitudinal studies have demonstrated that improvement of symptoms and airway hyperresponsiveness may be prolonged after cessation of exposure. Severity of asthma at diagnosis is the best predictor of clinical symptoms and functional impairment at follow-up. The molecular weight of the causal agent does not seem to be a prognostic factor. Airway inflammation is associated with persistence of symptoms and airway hyperresponsiveness after cessation of exposure. Reduction of exposure has proved to be effective in improvement of latex-induced asthma.
Further studies are needed to investigate the prognostic value of sputum eosinophils and neutrophils, and to determine whether some specific agents are associated with a better prognosis than others.
职业性哮喘常伴有严重的工作和经济后果。职业性哮喘的正确管理必须基于对该疾病自然史及其预后因素的充分了解。
纵向研究表明，接触停止后症状和气道高反应性的改善可能会持续较长时间。诊断时哮喘的严重程度是随访时临床症状和功能损害的最佳预测指标。致病因子的分子量似乎不是一个预后因素。气道炎症与接触停止后症状和气道高反应性的持续存在有关。减少接触已被证明对改善乳胶诱发的哮喘有效。
需要进一步研究以探讨痰液嗜酸性粒细胞和中性粒细胞的预后价值，并确定某些特定因素是否比其他因素具有更好的预后。
