Ryan G, Musk A W, Perera D M, Stock H, Knight J L, Hobbs M S
Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Perth, WA.
Aust N Z J Med. 1991 Oct;21(5):681-5. doi: 10.1111/j.1445-5994.1991.tb01370.x.
Hospital records of patients with asthma admitted to teaching hospitals in Perth, Western Australia between 1976 and 1980 were examined retrospectively to identify characteristics of the illness which were associated with subsequent death. From 5722 admissions there were 195 deaths to December 1982, 186 of whom had records available (cases); 452 of the surviving subjects were used for comparison (controls). There was no difference in age of onset of asthma or cigarette smoking habits between the two groups, but ischaemic heart disease as an associated condition was significantly more frequent in cases. On admission to hospital an arterial PCO2 less than 45 mmHg was more frequent in those who died, but there were no differences in arterial PO2, lowest pH, highest or lowest FEV1 and FVC. Cases more frequently used home nebulisers and were more frequently prescribed corticosteroids, antibiotics and sedatives or tranquilizers prior to admission, corticosteroids and sedatives or tranquilisers during admission and sedatives or tranquilisers on discharge. These results suggest that cases had more severe asthma in that they were more often treated with home nebulisers, corticosteroids and antibiotics, but with the exception of PaCO2 the commonly used measurements of severity of asthma did not identify those at risk of death. The prescription of sedatives or tranquillisers appears to be associated with an increased risk of death in subjects with asthma.
对1976年至1980年间西澳大利亚州珀斯市教学医院收治的哮喘患者的医院记录进行了回顾性检查，以确定与随后死亡相关的疾病特征。在5722例入院患者中，到1982年12月有195例死亡，其中186例有可用记录（病例）；452例存活患者用作对照。两组之间哮喘发病年龄或吸烟习惯没有差异，但缺血性心脏病作为相关疾病在病例中明显更常见。入院时，动脉血二氧化碳分压低于45 mmHg在死亡患者中更常见，但动脉血氧分压、最低pH值、最高或最低第一秒用力呼气容积（FEV1）和用力肺活量（FVC）没有差异。病例更频繁地使用家用雾化器，在入院前更频繁地使用皮质类固醇、抗生素和镇静剂或 tranquilizers，入院期间使用皮质类固醇和镇静剂或tranquilisers，出院时使用镇静剂或tranquilisers。这些结果表明，病例的哮喘更严重，因为他们更经常接受家用雾化器、皮质类固醇和抗生素治疗，但除了动脉血二氧化碳分压外，常用的哮喘严重程度测量方法并不能识别出有死亡风险的患者。镇静剂或tranquilisers的处方似乎与哮喘患者的死亡风险增加有关。 （注：tranquilisers这个词原文拼写有误，可能是tranquilizers，翻译为“镇静剂” ）
