Dept of Respiratory Medicine, Academic Medical Centre, Amsterdam, The Netherlands.
Eur Respir J. 2013 Sep;42(3):655-61. doi: 10.1183/09031936.00150312. Epub 2012 Dec 20.
Increasing evidence suggests that patients with asthma have activated coagulation within the airways. Whether this leads to an increase in venous thromboembolic events is unknown. We therefore assessed the incidence of venous thromboembolic events in patients with mild-to-moderate and severe asthma as compared with an age- and sex-matched reference population. 648 patients with asthma (283 with severe and 365 patients with mild-to-moderate asthma) visiting three Dutch outpatient asthma clinics were studied. All patients completed a questionnaire about a diagnosis of deep vein thrombosis and pulmonary embolism in the past, their risk factors, history of asthma and medication use. All venous thromboembolic events were objectively verified. In total, 35 venous thromboembolic events (16 deep vein thrombosis and 19 pulmonary embolism) occurred at a median age of 39 (range 20-63) years. The incidence of pulmonary embolism in patients with severe asthma was 0.93 (95% CI 0.42-1.44) per 1000 person-years, 0.33 (95% CI 0.07-0.60) in mild-to-moderate asthma and 0.18 (95% CI 0.03-0.33) in the general population, respectively. Severe asthma and oral corticosteroid use were independent risk factors of pulmonary embolism (hazard ratios 3.33 (1.16-9.93) and 2.82 (1.09-7.30), respectively). Asthma was not associated with deep vein thrombosis. Severe asthma greatly enhances the risk of pulmonary embolism, particularly if chronic corticosteroids are used.
越来越多的证据表明，哮喘患者的气道存在凝血激活。但尚不清楚这是否会导致静脉血栓栓塞事件增加。因此，我们评估了轻度至中度和重度哮喘患者与年龄和性别匹配的参考人群相比，静脉血栓栓塞事件的发生率。研究了三家荷兰门诊哮喘诊所的 648 名哮喘患者（283 名严重哮喘患者和 365 名轻度至中度哮喘患者）。所有患者都完成了一份关于过去深静脉血栓形成和肺栓塞诊断、其危险因素、哮喘病史和药物使用的问卷。所有静脉血栓栓塞事件均经客观证实。共有 35 例静脉血栓栓塞事件（16 例深静脉血栓形成和 19 例肺栓塞）发生，中位年龄为 39 岁（范围 20-63 岁）。重度哮喘患者的肺栓塞发生率为每 1000 人年 0.93（95%CI 0.42-1.44），轻度至中度哮喘为 0.33（95%CI 0.07-0.60），普通人群为 0.18（95%CI 0.03-0.33）。重度哮喘和口服皮质类固醇的使用是肺栓塞的独立危险因素（危险比分别为 3.33（1.16-9.93）和 2.82（1.09-7.30））。哮喘与深静脉血栓形成无关。重度哮喘极大地增加了肺栓塞的风险，尤其是在长期使用皮质类固醇的情况下。
