Medici T C, Vetter W
Departement für Innere Medizin der Universität Zürich.
Schweiz Med Wochenschr. 1991 Apr 6;121(14):501-8.
Epidemiological studies show considerable geographic differences in asthma prevalence and mortality. The regions with high prevalence and mortality are countries with Western-type culture and a high degree of technological progress. They differ from less technically developed countries in a number of ways, including their higher salt intake. Air pollution is often given as the cause of the high prevalence of asthma in the industrialized countries. Against this, it must be pointed out that in the urban agglomerations of the developing countries and in rural areas where heating is by means of open fireplaces (indoor pollution), there is also considerable air pollution. Migration studies from New Zealand and South Africa, where asthma prevalence increases parallel to salt intake, provide evidence that other factors arising from westernization and urbanization play a role. In the industrialized countries England and USA there is also a clear connection between salt intake and asthma: the greater the salt consumption, the higher the asthma prevalence and mortality. On the basis of these observations, the following questions were investigated: (1.) Does salt loading worsen the clinical and functional findings in asthmatics? (2.) Is the sodium or the chloride in salt the more important? To answer these questions, the effect of salt loading (+6.1 +/- 2.8 g NaCl/d = 105 +/- 48 mmol Na), salt restriction, and loading with sodium citrate in equimolar concentrations (+140 +/- 40 ml Shohl's solution = 120 +/- 34 mmol Na) was investigated in 14 asthmatics in a controlled crossover study. Statistical analysis showed that salt intake worsened symptoms (p = 0.06) and increased the use of inhaled steroids (p less than or equal to 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
流行病学研究表明,哮喘患病率和死亡率存在显著的地域差异。患病率和死亡率较高的地区是具有西方文化类型且技术进步程度较高的国家。它们在许多方面与技术欠发达国家不同,包括盐摄入量更高。空气污染常被认为是工业化国家哮喘高患病率的原因。与此相反,必须指出的是,在发展中国家的城市群以及使用明火取暖的农村地区(室内污染),也存在相当严重的空气污染。来自新西兰和南非的移民研究表明,哮喘患病率与盐摄入量平行增加,这证明西化和城市化带来的其他因素也起到了作用。在工业化国家英国和美国,盐摄入量与哮喘之间也存在明显联系:盐消耗量越大,哮喘患病率和死亡率越高。基于这些观察结果,研究了以下问题:(1)盐负荷是否会使哮喘患者的临床和功能表现恶化?(2)盐中的钠或氯哪个更重要?为了回答这些问题,在一项对照交叉研究中,对14名哮喘患者进行了盐负荷(+6.1±2.8克氯化钠/天 = 105±48毫摩尔钠)、限盐以及等摩尔浓度柠檬酸钠负荷(+140±40毫升肖尔溶液 = 120±34毫摩尔钠)的研究。统计分析表明,盐摄入会使症状恶化(p = 0.06)并增加吸入性类固醇的使用(p≤0.05)。(摘要截断于250字)