Giamarchi D, Escamilla R, Pourrut J C, Krempf M, Migueres J
Service des Maladies Respiratoires, C.H.U. de Rangueil, Toulouse.
Allerg Immunol (Paris). 1989 Feb;21(2):72-5.
One of the etiological factors of female late onset asthma lies in endocrine disorders and it often occurs during a period of hormonal instability (menopause or premenopause). Moreover various studies have shown increased allergic manifestations in women with gynecological problems (dysmenorrhea, premenstrual syndrome). Gynecological pathology is found in 30% of 67 women who suffer from late onset asthma. Prospective studies were carried out in 28 women with surgical uterine fibroma, to investigate bronchial hyperreactivity (BHR). The study included atopic research through questioning and allergy skin tests; spirographic respiratory function study, airway resistance, carbachol BHR with determination of the threshold dose (FEV1 20% decrease). Carbachol BHR was found in 8/28 persons (28%), but with no clinical manifestations. None of the patients smoke and only one suffers from mite-allergic rhinitis-conjunctivitis without asthma. BHR is often found in asymptomatic women with uterine fibroma. Is this BHR due to an autonomic dysregulation or to a hormonal malfunction? This hypothesis would require further studies to elucidate, since premenstrual asthma worsening is a well known phenomenon, which can be improved by progesterone. This may suggest a possible link between hormonal malfunction and BHR in women. A long term survey will facilitate detection of late onset asthma.
女性迟发性哮喘的病因之一在于内分泌紊乱,且其常发生于激素不稳定时期(绝经或绝经前)。此外,多项研究表明,患有妇科问题(痛经、经前综合征)的女性过敏表现增多。在67例迟发性哮喘女性患者中,30%存在妇科病理问题。对28例患有子宫平滑肌瘤的女性进行了前瞻性研究,以调查支气管高反应性(BHR)。该研究包括通过询问和过敏皮肤试验进行特应性研究;肺量计呼吸功能研究、气道阻力、卡巴胆碱支气管高反应性及阈剂量测定(第一秒用力呼气容积下降20%)。在28人中,8人(28%)发现有卡巴胆碱支气管高反应性,但无临床表现。所有患者均不吸烟,只有1人患有螨过敏性鼻炎-结膜炎,无哮喘。支气管高反应性常见于患有子宫平滑肌瘤的无症状女性。这种支气管高反应性是由于自主神经调节异常还是激素功能紊乱所致?这一假设需要进一步研究阐明,因为经前哮喘加重是一个众所周知的现象,可用黄体酮改善。这可能提示女性激素功能紊乱与支气管高反应性之间可能存在联系。长期调查将有助于迟发性哮喘的发现。