Settipane R A, Schrank P J, Simon R A, Mathison D A, Christiansen S C, Stevenson D D
Division of Allergy and Immunology, Scripps Clinic and Research Foundation, La Jolla, CA 92037, USA.
J Allergy Clin Immunol. 1995 Oct;96(4):480-5. doi: 10.1016/s0091-6749(95)70290-3.
Cross-sensitivity between aspirin and acetaminophen in aspirin-sensitive asthmatic patients has been reported with frequencies ranging from 0% to 29%. The relationship is dose-dependent for acetaminophen challenges, ranging between 300 and 100 mg.
To determine the prevalence of cross-sensitivity to high-dose acetaminophen, we performed single-blind acetaminophen oral challenges with 1000 mg and 1500 mg in 50 aspirin-sensitive asthmatic patients and in 20 non-aspirin-sensitive asthmatic control subjects.
Overall, 17 of 50 (34%) of aspirin-sensitive asthmatic patients reacted to acetaminophen in doses of 1000 to 1500 mg (95% confidence interval: 20% to 49%). By contrast, none of the 20 non-aspirin-sensitive asthmatic patients reacted to acetaminophen (95% confidence interval: 0% to 14%). This difference was highly significant (p = 0.0013), supporting the hypothesis that cross-sensitivity between aspirin and acetaminophen is unique in aspirin-sensitive asthmatic patients.
Although high-dose ( > 1000 mg) acetaminophen cross-reactions with aspirin were significant with respect to frequency (34%), such reactions included easily reversed bronchospasm in only 22%, and were generally mild. We recommended that high doses of acetaminophen (1000 mg or greater) should be avoided in aspirin-sensitive asthmatic patients.
据报道，阿司匹林敏感型哮喘患者中阿司匹林与对乙酰氨基酚之间的交叉敏感性频率在0%至29%之间。对乙酰氨基酚激发试验的这种关系呈剂量依赖性，剂量范围在300至100毫克之间。
为了确定对高剂量对乙酰氨基酚的交叉敏感性患病率，我们对50名阿司匹林敏感型哮喘患者和20名非阿司匹林敏感型哮喘对照受试者进行了1000毫克和1500毫克对乙酰氨基酚的单盲口服激发试验。
总体而言，50名阿司匹林敏感型哮喘患者中有17名（34%）对1000至1500毫克剂量的对乙酰氨基酚有反应（95%置信区间：20%至49%）。相比之下，20名非阿司匹林敏感型哮喘患者中无人对对乙酰氨基酚有反应（95%置信区间：0%至14%）。这种差异非常显著（p = 0.0013），支持了阿司匹林与对乙酰氨基酚之间的交叉敏感性在阿司匹林敏感型哮喘患者中是独特的这一假设。
尽管高剂量（>1000毫克）对乙酰氨基酚与阿司匹林的交叉反应在频率方面很显著（34%），但此类反应中仅22%包括易于逆转的支气管痉挛，且一般症状较轻。我们建议阿司匹林敏感型哮喘患者应避免使用高剂量对乙酰氨基酚（1000毫克或更高）。
