阿司匹林相关气道高反应的危险因素分析

Analysis of risk factors for aspirin-related airway hyperresponsiveness

目的:评估花生四烯酸(AA)诱导的血小板聚集率与阿司匹林相关气道高反应的相关性,探讨阿司匹林相关气道高反应的危险因素。方法:收集93例新发冠心病且既往未服用阿司匹林的患者,完善血小板聚集试验、肺功能及支气管激发试验。根据气道反应性,分为气道高反应组与气道正常反应组,比较2组患者临床特点、血小板聚集率及支气管激发试验结果。结果:52例(55.91%)患者气道激发试验阳性。根据AA诱导的血小板聚集率是否<10%,分为血小板低聚集率组和血小板高聚集率组。Logistic回归分析表明AA诱导的血小板聚集率低的患者气道高反应发生风险增加2.5倍(OR=2.50,95%CI:1.079~5.792)。吸烟可能增加2.9倍气道高反应发生的风险(OR=2.87995%CI:1.182~7.014)。结论:AA诱导的血小板聚集率明显降低(<10%)和吸烟是阿司匹林介导气道高反应的独立危险因素。戒烟及监测血小板聚集试验对阿司匹林相关哮喘发作有积极的预防作用。

Objective:To evaluate the correlation between arachidonic acid(AA)-induced platelet aggregation rate and aspirin-related airway hyperresponsiveness and to explore the risk factors of aspirin-related airway hyperresponsiveness.Method:A total of 93 patients with coronary heart disease who have not taken aspirin were collected,and the platelet aggregation test,lung function and bronchial provocation tests were performed.According to airway responsiveness,the patients were divided into airway high response group and normal group.The clinical characteristics,platelet aggregation rate and bronchial provocation test results of the two groups were compared.Results:Fifty-two patients(55.91%)had positive airway provocation test.According to whether the platelet aggregation rate induced by AA was less than 10%,the patients were divided into low platelet aggregation rate group and high aggregation rate group.Logistic regression analysis showed that patients with a low rate of platelet aggregation induced by AA increased the risk of airway hyperresponsiveness by 2.5 times.Smoking was also an independent risk factor for aspirin-related airway hyperresponsiveness,which may increase the risk of airway hyperresponse by 2.9 times(OR=2.879,95%CI:1.182-7.014).Conclusion:AA-induced platelet aggregation rate decreased significantly(less than 10%)and smoking history is independent risk factors for aspirin-mediated airway hyperresponsiveness.Quitting smoking and detecting platelet aggregation tests can actively prevent aspirin-related asthma attacks.