Nogami N, Kishikawa R, Odajima H, Tsurutani H, Hirose T, Nishima S
National Minami Fukuoka Chest Hospital.
Arerugi. 1993 Apr;42(4):514-21.
To characterize asthma in the elderly, we compared asthma in patients aged over 70 without chronic obstructive pulmonary disease with that in patients in their twenties. In the elderly, 65.5% of the patients had developed asthma after they were fifty years old. The mean duration from onset of asthma was 21.4 years. Of cases in the elderly, 42.1% were severe, and 93.0% were chronic type. IgE was significantly lower in the elderly than in those in their twenties. Among the patients in their twenties, the severe cases had early onset and long duration. In the elderly, however, there were no correlations between severity and age at onset or duration. Severe cases in their twenties had more obstructive ventilatory dysfunction in the stable state than the mild cases. In the elderly, however, the mild cases had the same level of obstructive ventilatory dysfunction as the severe cases. The elderly patients who had more than twenty years duration had lower V50 and V25 than those who had a less than twenty-year history. Small airway obstruction was observed in long-standing cases. As asthma in the elderly causes obstructive ventilatory dysfunction in the stable state, elderly patients might easily develop respiratory failure, even during mild attacks.
为了描述老年人哮喘的特征，我们将70岁以上无慢性阻塞性肺疾病的哮喘患者与二十多岁的患者进行了比较。在老年人中，65.5%的患者在50岁以后患上哮喘。哮喘发病的平均时长为21.4年。在老年患者中，42.1%为重度，93.0%为慢性型。老年人的免疫球蛋白E（IgE）显著低于二十多岁的人。在二十多岁的患者中，重度病例起病早且病程长。然而，在老年人中，严重程度与发病年龄或病程之间没有相关性。二十多岁的重度病例在稳定状态下的阻塞性通气功能障碍比轻度病例更多。然而，在老年人中，轻度病例的阻塞性通气功能障碍程度与重度病例相同。病程超过20年的老年患者的V50和V25低于病程不足20年的患者。在病程较长的病例中观察到小气道阻塞。由于老年人哮喘在稳定状态下会导致阻塞性通气功能障碍，老年患者即使在轻度发作期间也可能容易发生呼吸衰竭。
