Grzelewska-Rzymowska I, Roznlecki J, Szmidt M
Department of Pneumonology and Allergology, Medical Academy of Lódź, Poland.
Allergol Immunopathol (Madr). 1988 Sep-Oct;16(5):305-8.
The study was performed on 22 patients with sensitivity to aspirin which manifested as urticaria and angioedema. Sensitivity to aspirin was established based on the anamnesis of urticaria and angioedema occurring after ingestion of aspirin and oral challenge tests with acetylsalicylic acid. At first, the threshold dose of aspirin in all patients and additionally of indomethacin in 12 patients was established. Aspirin "desensitization" was induced by administering increasing doses of acetylsalicylic acid every 24 hr until a good tolerance of 600 mg was obtained. The following day after the ingestion of 600 mg acetylsalicylic acid, 12 patients received 50 mg indomethacin. A good tolerance of 600 mg aspirin was achieved in all examined patients and 50 mg of indomethacin was also well tolerated. The authors assume that mechanism of urticaria and angioedema type of sensitivity to aspirin has the same pathogenic background as aspirin-induced bronchoconstriction.
该研究针对22例对阿司匹林敏感的患者进行,其敏感表现为荨麻疹和血管性水肿。基于摄入阿司匹林后出现荨麻疹和血管性水肿的病史以及乙酰水杨酸的口服激发试验确定对阿司匹林的敏感性。首先,确定了所有患者中阿司匹林的阈值剂量,另外还确定了12例患者中吲哚美辛的阈值剂量。通过每24小时给予递增剂量的乙酰水杨酸直至获得600mg的良好耐受性来诱导阿司匹林“脱敏”。在摄入600mg乙酰水杨酸后的第二天,12例患者服用50mg吲哚美辛。所有接受检查的患者均对600mg阿司匹林有良好耐受性,对50mg吲哚美辛也耐受良好。作者认为,荨麻疹和血管性水肿型阿司匹林敏感性的机制与阿司匹林诱导的支气管收缩具有相同的致病背景。