Szczeklik Wojciech, Sokołowska Barbara Magdalena, Zuk Joanna, Mastalerz Lucyna, Szczeklik Andrew, Musiał Jacek
Department of Medicine, Jagiellonian University Medical College, Skawinska, Krakow, Poland.
J Asthma. 2011 Mar;48(2):183-7. doi: 10.3109/02770903.2010.551796. Epub 2011 Jan 20.
Asthma is one of the key features of Churg-Strauss syndrome (CSS); however its course in the disease is unclear. The aim of this study was to analyze the asthma course in CSS patients.
We conducted a retrospective study of 22 CSS patients. Medical documentation was studied and patients were questioned about asthma symptoms during follow-up visits, which took place at four points of the disease. These points, at which lung function tests were performed, were CSS diagnosis; introduction of treatment at hospital discharge; and assessment of the first and last clinical and laboratory CSS remissions. Asthma control and severity were assessed in compliance with current guidelines.
In the asthmatic group examined, 21 patients had an adult-onset asthma, with a mean age of onset 35.5 ± 11.8 years, preceded by sinusitis (100%) and nasal polyposis (36%). Asthma at its onset was severe in 68.5%, moderate in 27%, and very poorly controlled in 21 patients. Atopy was present in 64% of patients. Onset of vasculitic symptoms and CSS diagnosis was accompanied by high blood eosinophilia (maximal 7.2 x 10(3)/l [1.2 - 32], asthma exacerbation with airway obstruction in 16 patients (mean values of FEV1 68.8 ± 17.5% and FVC 84.8 ± 19.6%), and lung involvement. After introducing the treatment and achieving stable remission, asthma severity/control and lung function tests (forced expiratory volume in 1 s 92.7 ± 13.3%, and forced vital capacity 101 ± 15.5%; p < .001) improved.
Asthma in CSS, although severe as its onset improves after achieving CSS remission.
哮喘是变应性肉芽肿性血管炎（CSS）的关键特征之一；然而其在该疾病中的病程尚不清楚。本研究的目的是分析CSS患者的哮喘病程。
我们对22例CSS患者进行了一项回顾性研究。研究了医疗记录，并在疾病的四个阶段进行随访时询问患者有关哮喘症状。在这些阶段进行了肺功能测试，分别为CSS诊断时；出院时开始治疗时；以及首次和最后一次临床及实验室CSS缓解评估时。根据当前指南评估哮喘控制情况和严重程度。
在所检查的哮喘组中，21例患者为成人起病型哮喘，平均起病年龄为35.5±11.8岁，起病前均有鼻窦炎（100%）和鼻息肉（36%）。哮喘起病时68.5%为重度，27%为中度，21例控制极差。64%的患者有特应性。血管炎症状的出现和CSS诊断伴有高血嗜酸性粒细胞增多（最高7.2×10³/l[1.2 - 32]），16例患者出现伴有气道阻塞的哮喘加重（第1秒用力呼气量平均值为68.8±17.5%，用力肺活量为84.8±19.6%），以及肺部受累。开始治疗并实现稳定缓解后，哮喘严重程度/控制情况及肺功能测试（第1秒用力呼气量92.7±13.3%，用力肺活量101±15.5%；p<0.001）有所改善。
CSS中的哮喘虽然起病时严重，但在实现CSS缓解后有所改善。
