一例重症/难治性哮喘合并肺栓塞的机制探究和体会

Exploration and experience of one case of severe/refractory asthma complicated with pulmonary embolism

目的通过病例报道及文献回顾探讨重症/难治性哮喘合并肺栓塞的可能机制,并提供经验和更全面的认识。方法报道中日友好医院收治的1例重症/难治性哮喘合并肺栓塞患者,并对已发表的重症/难治性哮喘合并肺栓塞国内外文献进行归纳总结。结果国内关于哮喘合并肺栓塞的文献报道不多见,但是国外文献研究显示,其发病率并不低,临床医师在临床工作中应重视哮喘合并肺栓塞的病例。结论哮喘患者需经常使用皮质激素治疗,重症/难治性哮喘则需长期口服皮质激素控制,加上低氧、气道炎症刺激均为血栓形成的高危因素,此为重症/难治性哮喘合并肺栓塞的可能机制。

Objective To explore the mechanism and provide more comprehensive understanding of severe/refractory asthma complicated with pulmonary embolism through case reports and literature review. Methods A patient with severe/refractory asthma complicated with pulmonary embolism admitted to China-Japan Friendship Hospital was reported, and the related literatures published at home and abroad were summarized. Results Domestic literatures on asthma complicated with pulmonary embolism were rare, but foreign studies had shown that its incidence was not low.The clinicians should pay more attention to asthma complicated with pulmonary embolism. Conclusions Patients with asthma are often treated with corticosteroids.In addition, patients with severe/refractory asthma require long-term oral corticosteroid control.Hypoxia and airway inflammation are high risk factors for thrombosis.These may be the possible mechanisms for severe/refractory asthma complicated with pulmonary embolism.