Campbell D A, Luke C G, McLennan G, Coates J R, Frith P A, Gluyas P A, Latimer K M, Martin A J, Ruffin R E, Yellowlees P M, Roder D M
Department of Respiratory Medicine, Austin & Repatriation Medical Centre, Melbourne, Vic.
Aust N Z J Med. 1996 Jun;26(3):356-62. doi: 10.1111/j.1445-5994.1996.tb01922.x.
Self-reported prior morbidity levels and medication use among survivors of a near-fatal asthma attack (NFA) were studied.
To identify deficiencies in asthma management and opportunities for intervention.
A hundred and twenty-seven consecutive patients aged 15 years or more presenting with a NFA to accident and emergency departments of teaching hospitals were interviewed.
High levels of morbidity due to asthma were reported. Most cases (79%) reported symptoms occurring at least weekly in the three months before their NFA. A mean of 20.8 days was reportedly lost from work, school or other usual daily activity in the 12 months before these events. Regular use of beta agonist as nebuliser solution was reported by 27% of cases, increasing to 34.5% in response to increased symptoms, while 41% reported use of nebulised beta agonist in response to the NFA event. Less than half of all cases (46%) reported using an inhaled corticosteroid on a regular basis. Oral corticosteroids were used by 33% of cases at times of increased symptoms in the preceding 12 months. However, only 7% of cases reported initiating or increasing oral corticosteroids at the time of the NFA.
Despite high levels of prior asthma morbidity, regular preventive inhaled corticosteroid use was not widespread in this series of NFA asthmatics. By comparison, over-reliance on regular beta agonist medication was common. Oral corticosteroids were rarely commenced in response to the NFA.
对近致死性哮喘发作（NFA）幸存者自我报告的既往发病水平和药物使用情况进行了研究。
确定哮喘管理中的不足和干预机会。
对连续127例年龄在15岁及以上因NFA到教学医院急诊科就诊的患者进行了访谈。
报告了因哮喘导致的高发病水平。大多数病例（79%）报告在其NFA前三个月症状至少每周出现一次。据报道，在这些事件发生前的12个月里，平均有20.8天无法工作、上学或进行其他日常活动。27%的病例报告定期使用β受体激动剂雾化溶液，症状加重时这一比例增至34.5%，而41%的病例报告因NFA事件使用雾化β受体激动剂。所有病例中不到一半（46%）报告定期使用吸入性糖皮质激素。在过去12个月症状加重时，33%的病例使用口服糖皮质激素。然而，只有7%的病例报告在NFA时开始使用或增加口服糖皮质激素。
尽管既往哮喘发病率较高，但在这一系列NFA哮喘患者中，定期预防性使用吸入性糖皮质激素并不普遍。相比之下，过度依赖常规β受体激动剂药物很常见。因NFA而开始使用口服糖皮质激素的情况很少见。
