Nicolet-Chatelain G
Hôpital cantonal universitaire, Genève.
Rev Med Suisse Romande. 1997 Jun;117(6):465-70.
Exercise induced-asthma (EIA) is a frequent symptom concerning about 12% of the general population and at least 90% of asthmatics. It is often the first manifestation of asthma and is underestimated both by the patient and the practitioner. The pathophysiological mechanism is dealing with thermodynamic changes of bronchial mucosa, however it is not completely elucidated. Rapid cooling of bronchial mucosa and rewarming of expired air induces bronchial hyper circulation, hyperosmolarity and mast cell infiltration with release of mediators responsible for the bronchial narrowing after exercise. The diagnosis of EIA is usually historical. The measurement of peak flow after the exercise is the easiest way to confirm the diagnostic. Provocation tests in laboratory are sometimes useful. Warm-up protocoles are insufficient to prevent EIA in athletes. The beta-2-mimetics are the first choice drugs and may be associated with nedocromil-cromolyn if necessary. Inhaled corticosteroids are effective in long term administration, but it is a treatment of third choice. When corticosteroids are necessary, "unstable" asthma should be suspected.
运动诱发性哮喘（EIA）是一种常见症状，约12%的普通人群及至少90%的哮喘患者会出现。它常是哮喘的首发表现，患者和医生对此均认识不足。其病理生理机制与支气管黏膜的热力学变化有关，但尚未完全阐明。支气管黏膜的快速冷却和呼出气体的复温会导致支气管血液循环加速、高渗状态以及肥大细胞浸润，并释放导致运动后支气管狭窄的介质。EIA的诊断通常基于病史。运动后测量峰值流速是确诊的最简单方法。实验室激发试验有时也有用。热身方案对预防运动员的EIA并不充分。β-2激动剂是首选药物，必要时可与奈多罗米-色甘酸钠联用。吸入性糖皮质激素长期使用有效，但属于三线治疗药物。当需要使用糖皮质激素时，应怀疑为“不稳定型”哮喘。
