Ferrer A, Torres A, Roca J, Sunyer J, Antó J M, Rodriguez-Roisin R
Servei de Pneumologia, Facultat de Medicina, Universitat de Barcelona, Spain.
Eur Respir J. 1990 Apr;3(4):429-33.
Patients presenting with acute severe asthma during the Barcelona's outbreaks caused by soybean dust inhalation from August, 1981, through September, 1987, characteristically showed an abrupt severe onset of each attack followed by a rapid relief of symptoms after treatment. To throw further light on clinical findings, pathophysiology and outcome in the most life-threatening episodes, we reviewed records of acute severe asthma patients treated by mechanical ventilation in one of the four main hospitals of the city. Twelve such patients (15 episodes) were compared to 24 non-epidemic asthmatic patients (25 episodes) also treated by mechanical ventilation in the same institution during the same period of time. There was a male predominance during outbreaks (p less than 0.03) and epidemic patients were ventilated fewer hours (12 +/- 8 h) (mean +/- SD), admitted fewer days to intensive care (1.6 +/- 0.7 days), and hospitalized fewer days (7.1 +/- 4.4 days) than non-epidemic patients (65 +/- 84 h, 4.6 +/- 3.8 days (p less than 0.001, each), and 16.0 +/- 13.2 days (p less than 0.004), respectively). These differences together with both the fulminant presentation of the episodes of epidemic asthma and the point-source origin of the asthma outbreaks previously shown are consistent with the unusual nature of the aetiologic agent, soybean dust.
在1981年8月至1987年9月巴塞罗那因吸入大豆粉尘爆发疫情期间出现急性重症哮喘的患者，其每次发作的特点是起病突然且严重，治疗后症状迅速缓解。为了进一步阐明最危及生命的发作中的临床发现、病理生理学和结局，我们回顾了该市四家主要医院之一接受机械通气治疗的急性重症哮喘患者的记录。将12例此类患者（15次发作）与同期在同一机构接受机械通气治疗的24例非疫情期哮喘患者（25次发作）进行比较。疫情期间男性占主导（p<0.03），与非疫情期患者相比，疫情期患者机械通气时间更少（12±8小时）（平均值±标准差），入住重症监护病房天数更少（1.6±0.7天），住院天数更少（7.1±4.4天），而非疫情期患者分别为（65±84小时）、（4.6±3.8天（p<0.001，每项））和（16.0±13.2天（p<0.004））。这些差异，连同疫情期哮喘发作的暴发性表现以及先前显示的哮喘爆发的点源起源，均与致病因子大豆粉尘的特殊性质相符。
