Jindal S K, Gupta D, Singh A
Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Chest. 1994 Sep;106(3):746-9. doi: 10.1378/chest.106.3.746.
The study was undertaken to compare the indices of morbidity and control of asthma in 100 adult patients exposed to environmental tobacco smoke (ETS) inhalation (group 2), with 100 asthmatics not exposed (group 1). Exposure was established from the history of smoking by the patient's spouse and other close contacts. Asthma control and morbidity were assessed during their follow-up visits in the chest outpatient clinic by inquiring into the emergency department (ED) visits, hospitalization, acute episodes, requirement of parenteral drugs at home, corticosteroids, and maintenance bronchodilators in the preceding 1-year period. Index per patient was also calculated. Lung function was recorded by the measurement of forced expiratory flows on the same day of the follow-up visit. The mean age and disease duration were comparable, but the expiratory flows were lower in the patients exposed to ETS. More patients in group 2 required daily bronchodilators (66 percent) and intermittent corticosteroids (56 percent). The number of ED visits, acute episodes, and parenteral bronchodilators per patient were significantly more (p < 0.01) in group 2 patients. Similarly, the number of weeks of absence from work and of corticosteroid requirement were more (p < 0.01) in the ETS-exposed patients. We conclude that the control of asthma is poor and morbidity greater in adult patients with asthma exposed to ETS at home and/or at work.
本研究旨在比较100名吸入环境烟草烟雾(ETS)的成年哮喘患者(第2组)与100名未接触ETS的哮喘患者(第1组)的发病率和哮喘控制指标。通过患者配偶及其他密切接触者的吸烟史来确定是否接触ETS。在胸部门诊随访期间,通过询问前1年期间的急诊科就诊、住院、急性发作、在家中使用胃肠外给药、皮质类固醇和维持性支气管扩张剂的情况,评估哮喘控制情况和发病率。还计算了每位患者的指标。在随访当天通过测量用力呼气流量记录肺功能。两组患者的平均年龄和病程相当,但接触ETS的患者呼气流量较低。第2组中更多患者需要每日使用支气管扩张剂(66%)和间歇性使用皮质类固醇(56%)。第2组患者的每位患者急诊科就诊次数、急性发作次数和胃肠外支气管扩张剂使用次数显著更多(p<0.01)。同样,接触ETS的患者缺勤周数和皮质类固醇需求量更多(p<0.01)。我们得出结论,在家中和/或工作场所接触ETS的成年哮喘患者哮喘控制不佳且发病率更高。