Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Mass; Harvard Medical School, Boston, Mass.
Department of Medicine, Division of Rheumatology, Immunology, and Allergy, Brigham and Women's Hospital, Boston, Mass.
J Allergy Clin Immunol Pract. 2020 Feb;8(2):573-578.e4. doi: 10.1016/j.jaip.2019.08.054. Epub 2019 Sep 30.
Aspirin-exacerbated respiratory disease (AERD) is a condition of the upper and lower respiratory tract characterized by reactions to nonsteroidal anti-inflammatory drugs. The Severe Asthma Research Program reported a strong association between perimenstrual asthma (PMA) and aspirin-sensitive asthma.
To evaluate the prevalence and characteristics of PMA among a cohort of patients with AERD.
Women 18 years and older enrolled in the Brigham and Women's AERD registry were surveyed about their reproductive, asthma, and sinus history. Subjects reporting the development of asthma before menopause were included. Continuous and categorical variables were compared between those reporting menstruation as a trigger for asthma symptoms and those who did not. Covariates expected a priori to have a positive effect on the odds of PMA were included in a multivariate logistic regression model to test associations between PMA and clinical factors.
Among females of childbearing potential, 369 of 695 responded to the survey and 322 met inclusion criteria. Twenty-four percent of subjects (n = 74) reported PMA. Earlier age of AERD onset, concurrent worsening of sinus symptoms the week before or during menstruation, increased emergency department visits for asthma, and a change in the severity of respiratory symptoms at menopause were more common in PMA. Earlier age at first nonsteroidal anti-inflammatory drug-induced respiratory reaction and emergency department visits increased the odds of reporting PMA.
PMA and increased sinus symptoms with menstruation are common in females with AERD. Females with AERD should be counseled about upper and lower respiratory symptom deterioration with menstruation.
阿司匹林加重性呼吸系统疾病（AERD）是一种上、下呼吸道疾病，其特征为对非甾体抗炎药的反应。严重哮喘研究计划报告称，经前期哮喘（PMA）与阿司匹林敏感型哮喘之间存在很强的关联性。
评估 AERD 患者队列中 PMA 的流行率和特征。
对参加 Brigham 和妇女 AERD 注册中心的 18 岁及以上女性进行了关于其生殖、哮喘和鼻窦病史的调查。纳入了报告绝经前哮喘发作的受试者。对报告月经是哮喘症状诱因的患者和未报告的患者进行了连续和分类变量的比较。在多变量逻辑回归模型中纳入了预期对 PMA 的阳性影响的协变量，以测试 PMA 与临床因素之间的关联。
在有生育能力的女性中，695 名女性中有 369 名对调查做出了回应，其中 322 名符合纳入标准。24%的患者（n=74）报告有 PMA。更早的 AERD 发病年龄、在月经前或月经期间同时出现的鼻窦症状恶化、因哮喘而增加的急诊就诊次数，以及绝经时呼吸症状严重程度的变化在 PMA 中更为常见。首次非甾体抗炎药诱发的呼吸反应和急诊就诊的年龄更早，报告 PMA 的几率增加。
PMA 和月经期间鼻窦症状加重在 AERD 女性中很常见。应向 AERD 女性提供有关月经期间上、下呼吸道症状恶化的咨询。
