Suzuki Kazuo, Hasegawa Takashi, Sakagami Takuro, Koya Toshiyuki, Toyabe Shinichi, Akazawa Kohei, Arakawa Masaaki, Gejyo Fumitake, Suzuki Eiichi
Division of Respiratory Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
Allergol Int. 2007 Sep;56(3):249-55. doi: 10.2332/allergolint.O-06-475. Epub 2007 Jun 1.
Perimenstrual asthma (PMA) has been documented in 30% to 40% of asthmatic women; the characteristics of PMA have also been well described. However, there have been few epidemiological investigations of PMA in practice. In this study, we analyzed PMA based on a questionnaire survey carried out in Japan and compared the results with those of studies reported previously.
For 8 weeks from September through October 2004, a questionnaire survey was administered to patients with bronchial asthma and their attending physicians. The questionnaire surveyed asthma control, asthma-related emergencies and satisfaction in daily life. The attending physicians were questioned about patient profiles and medications. All female patients who were menstruating during the survey period and who were known to have asthma exacerbation related to menstruation were allocated to the PMA group; those who were not were allocated to the non-PMA group.
The rate of PMA in female patients who were menstruating during the survey period was 11.3% in this study. Characteristic features of the PMA group (n = 54) included more severe disease, worsened disease control and more aggressive patient management, including increased oral corticosteroid use compared with the non-PMA group. The rates of emergency episodes in the PMA group were higher than in the non-PMA group. There was a significant increase in aspirin intolerant asthma (AIA, 25.5%) in the PMA group compared with the non-PMA group (8.4%).
Attention should be paid to the lack of knowledge regarding PMA in patients with asthma in actual clinical settings. The low rate of PMA reported in this study may be due to the study method using self-reports of PMA by patients without sufficient knowledge, and may not be an accurate representation of the actual incidence of the disease. The clinical similarity of PMA to AIA in this study may also provide a new insight into the mechanism of PMA.
围经期哮喘（PMA）在30%至40%的哮喘女性患者中已有记载；PMA的特征也已得到充分描述。然而，在实际中对PMA进行的流行病学调查却很少。在本研究中，我们基于在日本进行的问卷调查对PMA进行了分析，并将结果与先前报道的研究结果进行了比较。
在2004年9月至10月的8周时间里，对支气管哮喘患者及其主治医生进行了问卷调查。该问卷调查了哮喘控制情况、与哮喘相关的紧急情况以及日常生活满意度。主治医生被询问了患者的基本情况和用药情况。所有在调查期间处于经期且已知有与月经相关的哮喘加重情况的女性患者被分配到PMA组；那些没有这种情况的患者被分配到非PMA组。
在本研究中，调查期间处于经期的女性患者中PMA的发生率为11.3%。PMA组（n = 54）的特征包括病情更严重、疾病控制情况恶化以及对患者的管理更积极，包括与非PMA组相比口服糖皮质激素的使用增加。PMA组的紧急发作率高于非PMA组。与非PMA组（8.4%）相比，PMA组中阿司匹林不耐受性哮喘（AIA，25.5%）的发生率显著增加。
在实际临床环境中，应注意哮喘患者对PMA缺乏了解的情况。本研究中报道的PMA发生率较低可能是由于采用了患者自我报告PMA的研究方法，而患者没有足够的知识，可能无法准确反映该疾病的实际发病率。本研究中PMA与AIA在临床上的相似性也可能为PMA的发病机制提供新的见解。
