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[妊娠期支气管哮喘的管理——匈牙利的经验]

[The management of bronchial asthma during pregnancy--Hungarian experiences].

作者信息

Tamási Lilla, Bohács Anikó, Pállinger Eva, Rigó János, Magyar Pál, Losonczy György

机构信息

Semmelweis Egyetem, Altalános Orvostudományi Kar, Pulmonológiai Klinika, Budapest.

出版信息

Orv Hetil. 2005 Nov 6;146(45):2305-9.

Abstract

INTRODUCTION

The prevalence of bronchial asthma is 4-8% among pregnant women. The complications, which threaten the asthmatic pregnancies according to the literature, are the following: spontaneous abortion, diabetes mellitus, caesarean delivery, pre-eclampsia, low gestational weight, neonatal icterus.

OBJECTIVE

The aim of the study was a retrospective analysis of the data of asthmatic pregnant patients managed between 2000 and 2004, with a special consideration on the treatment and gynecologic complications.

METHODS

The data of 53 persistent asthmatic patients--who had already undergone delivery--were collected. All of them were treated according to the guidelines issued in 2000 by the American College of Allergy, Asthma and Immunology and the American College of Obstetricians and Gynecologists: the inhalative corticosteroid budesonide, the long-acting beta-agonist formoterol or salmeterol and the short-acting beta-agonist terbutaline were used.

RESULTS

The mean peak expiratory flow of the asthmatic pregnant patients was 71 +/- 16% of predicted, and the mean partial arterial oxygen tension 96 +/- 9 mmHg (means +/- SE). 10 of the 53 patients had cesarean delivery, 3 developed pre-eclampsia, 1 diabetes mellitus. The mean gestational age was 38.84 +/- 2.17 weeks and the weight of newborns 3132 +/- 604 g. The hospitalization was prolonged due to the infants' hyperbilirubinaemia in 3 cases. No congenital malformations or spontaneous abortions were detected.

CONCLUSION

Based on the results of this retrospective study it can be concluded, that bronchial asthma slightly decreases the weight of newborns. The appropriate treatment of asthma during pregnancy resulted that the prevalence of gynecologic complications did not exceed the prevalence observed in the normal population--without increasing the risk of congenital malformations.

摘要

引言

孕妇中支气管哮喘的患病率为4%-8%。根据文献记载,威胁哮喘孕妇的并发症如下:自然流产、糖尿病、剖宫产、先兆子痫、低出生体重、新生儿黄疸。

目的

本研究的目的是对2000年至2004年期间管理的哮喘孕妇患者的数据进行回顾性分析,特别关注治疗和妇科并发症。

方法

收集了53例已分娩的持续性哮喘患者的数据。所有患者均按照美国过敏、哮喘与免疫学会和美国妇产科医师学会2000年发布的指南进行治疗:使用吸入性皮质类固醇布地奈德、长效β受体激动剂福莫特罗或沙美特罗以及短效β受体激动剂特布他林。

结果

哮喘孕妇患者的平均呼气峰值流速为预测值的71±16%,平均动脉血氧分压为96±9 mmHg(均值±标准误)。53例患者中有10例行剖宫产,3例发生先兆子痫,1例患糖尿病。平均孕周为38.84±2.17周,新生儿体重为3132±604 g。3例因婴儿高胆红素血症导致住院时间延长。未发现先天性畸形或自然流产。

结论

基于这项回顾性研究的结果可以得出结论,支气管哮喘会使新生儿体重略有下降。孕期对哮喘进行适当治疗的结果是,妇科并发症的发生率未超过正常人群的发生率,且未增加先天性畸形的风险。

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