Matsuse Hiroto, Tsuchida Tomoko, Fukahori Susumu, Kawano Tetsuya, Tomari Shinya, Matsuo Nobuko, Nishino Tomoya, Fukushima Chizu, Kohno Shigeru
Second Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki, Japan.
Department of Internal Medicine, Sasebo City General Hospital, Sasebo, Japan.
Allergy Rhinol (Providence). 2013 Fall;4(3):e127-31. doi: 10.2500/ar.2013.4.0062.
Upper respiratory tract infections (URIs) represent the most frequent cause of acute asthma exacerbations. It has yet to be determined whether leukotriene receptor antagonist (LTRA) treatment prevents URI-induced acute asthma exacerbations in adults. The objective of the present study was to evaluate the preventive effects of LTRA treatment on URI-induced acute asthma exacerbations. The incidences of URI alone, acute asthma exacerbation without URI, and URI-induced acute asthma exacerbation were determined retrospectively by analyzing diary and medical records of 321 adult asthmatic patients (mean age, 56.3 ± 17.2 years; male/female ratio, 117:204) over 1 year. Results were compared between patients who had been taking an LTRA (n = 137) and those who had never taken any LTRA (n = 184) during the study periods. Significantly fewer URIs alone and acute asthma exacerbations without URI occurred in patients with than in those without prophylactic daily use of LTRA. LTRA treatment significantly reduced the durations of URIs alone and of total acute asthma exacerbations, as well as the incidence of mild exacerbations of asthma. In contrast, in patients with URI-induced acute asthma exacerbations, LTRA treatment failed to significantly reduce the interval between URI onset and acute asthma exacerbation, as well as the duration and severity of both URIs and acute asthma exacerbations. Use of an LTRA for adult asthmatic patients appears to reduce the incidences of URIs alone and acute asthma exacerbations without URI, but it failed to prevent URI-induced acute asthma exacerbations once a URI occurred.
上呼吸道感染(URIs)是急性哮喘发作最常见的原因。白三烯受体拮抗剂(LTRA)治疗是否能预防成人因URIs诱发的急性哮喘发作尚待确定。本研究的目的是评估LTRA治疗对因URIs诱发的急性哮喘发作的预防作用。通过分析321例成年哮喘患者(平均年龄56.3±17.2岁;男女比例为117:204)1年的日记和病历,回顾性确定单纯URIs、无URIs的急性哮喘发作以及URIs诱发的急性哮喘发作的发生率。比较研究期间服用LTRA的患者(n = 137)和从未服用过任何LTRA的患者(n = 184)的结果。与未每日预防性使用LTRA的患者相比,服用LTRA的患者单纯URIs和无URIs的急性哮喘发作明显更少。LTRA治疗显著缩短了单纯URIs和急性哮喘发作的总时长,以及哮喘轻度发作的发生率。相比之下,在因URIs诱发急性哮喘发作的患者中,LTRA治疗未能显著缩短从URIs发作到急性哮喘发作的间隔时间,以及URIs和急性哮喘发作的时长和严重程度。对成年哮喘患者使用LTRA似乎可以降低单纯URIs和无URIs的急性哮喘发作的发生率,但一旦发生URIs,它无法预防URIs诱发的急性哮喘发作。