Yoshikawa T, Fujiuchi S, Inaba S, Nagai T, Terai T
First Department of Medicine, Obihiro Kosei Hospital, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1990 Jun;28(6):895-9.
Adverse reactions to preservatives contained in food and medications have been recognized with increasing frequency. We have recently seen an asthmatic patient in whom wheezing and dyspnea increased after injection of betamethasone. The patient was a 26-year-old woman who had had bronchial asthma since 1980. She was treated at another hospital for moderate wheezing and betamethasone injections were given in May 1988. After this treatment her condition deteriorated acutely and she was transferred to our hospital. To confirm the possible relationship between betamethasone (sulfite) and asthmatic attack, provocation challenge tests were conducted. Intradermal skin test revealed an immediate positive reaction to sodium bisulfite at a concentration of 100 mg/L. Challenge test with increasing amounts of sodium bisulfite showed a 52% decrease in FEV1, 50 min after inhalation of 5 mg/ml solution. In addition, another inhalation challenge was conducted by use of an Astograph. Rrs immediately increased during inhalation of 10 mg/ml solution. These results suggested that sulfite contained in betamethasone preparation provoked exaggerated bronchospasm in this patient.
食品和药物中所含防腐剂的不良反应已越来越频繁地被人们所认识。我们最近诊治了一名哮喘患者，该患者在注射倍他米松后喘息和呼吸困难加重。患者为一名26岁女性，自1980年起患有支气管哮喘。1988年5月，她在另一家医院接受治疗，当时喘息症状为中度，并接受了倍他米松注射。此次治疗后，她的病情急剧恶化，随后被转至我院。为了证实倍他米松（亚硫酸盐）与哮喘发作之间可能存在的关系，我们进行了激发试验。皮内皮肤试验显示，对浓度为100mg/L的亚硫酸氢钠立即出现阳性反应。吸入不同剂量亚硫酸氢钠的激发试验显示，吸入5mg/ml溶液50分钟后，第一秒用力呼气量（FEV1）下降了52%。此外，还使用哮喘仪进行了另一次吸入激发试验。吸入10mg/ml溶液期间，气道阻力（Rrs）立即增加。这些结果表明，倍他米松制剂中所含的亚硫酸盐引发了该患者过度的支气管痉挛。
