Department of Respiratory Medicine, Bispebjerg Hospital, Copenhagen NV, Denmark.
Expert Rev Respir Med. 2011 Jun;5(3):343-51. doi: 10.1586/ers.11.28.
Asthma is frequently found among elite athletes performing endurance sports such as swimming, rowing and cross-country skiing. Although these athletes often report symptoms while exercising, they seldom have symptoms at rest. Moreover, compared with nonathletic asthmatic individuals, elite athletes have been shown to have a different distribution of airway inflammation and unequal response to bronchial provocative test. Elite athletes display signs of exercise-induced symptoms, for example, nonasthmatic inspiratory wheeze, vocal cord dysfunction and cardiac arrhythmias, which could limit their physical capacity. Elite athletes should undergo comprehensive assessment to confirm an asthma diagnosis and determine its degree of severity. Treatment should be as for any other asthmatic individual, including the use of β2-agonist, inhaled steroid as well as leukotriene-antagonist. It should, however, be noted that daily use of β-agonists could expose elite athletes to the risk of developing tolerance towards these drugs. Use of β2-agonist should be replaced with daily inhaled corticosteroid treatment, the most important treatment of exercise-induced asthma. All physicians treating asthma should be aware of the doping aspects. Systemic β2-agonist intake is strictly prohibited, whereas inhaled treatment is allowed in therapeutic doses when asthma is documented and dispensation has been granted when needed.
哮喘在从事耐力运动的精英运动员中很常见，如游泳、划船和越野滑雪。尽管这些运动员在运动时经常报告有症状，但他们在休息时很少有症状。此外，与非运动性哮喘患者相比，精英运动员的气道炎症分布不同，对支气管激发试验的反应也不一致。精英运动员表现出运动引起的症状迹象，例如非哮喘性吸气性喘鸣、声带功能障碍和心律失常，这可能会限制他们的身体能力。精英运动员应进行全面评估以确认哮喘诊断并确定其严重程度。治疗应与任何其他哮喘患者一样，包括使用β2-激动剂、吸入性类固醇和白三烯拮抗剂。然而，应该注意的是，β-激动剂的日常使用可能会使精英运动员面临对这些药物产生耐受性的风险。应该用每日吸入皮质类固醇治疗代替β2-激动剂的使用，这是治疗运动性哮喘的最重要治疗方法。所有治疗哮喘的医生都应该了解兴奋剂方面的问题。系统使用β2-激动剂是严格禁止的，而当哮喘有记录且需要时给予了处方时，允许使用吸入治疗。
