51例职业性哮喘临床预后分析

Clinical prognosis analysis on 51 cases of occupational asthma

目的探讨职业性哮喘(OA)患者的预后及肺功能变化,为科学诊治提供依据。方法收集整理2008—2017年我院收治的51例职业性哮喘患者随访资料,回顾分析治疗方案、治疗效果及肺功能变化情况。结果所有患者在诊断职业性哮喘后,均调离了工作岗位,不再接触致喘物。在1~9年随访期间,有12例患者因哮喘急性发作曾至医院就诊。患者诊断治疗后1年与诊断时相比,哮喘控制水平分级、评分均有所好转,治疗方案降级,FEV1.0、FEV1.0/FVC%好转(P<0.05)。末次随访与诊断治疗后1年相比,哮喘控制水平分级、评分、肺功能虽有改善,但差异无统计学意义(P>0.05)。中度患者在随访1年时肺功能指标较诊断时明显改善,在末次随访时FEV1.0持续好转(P<0.05)。结论及时终止职业危害暴露以及给予个体化治疗后,大部分职业性哮喘患者预后较好,中度哮喘患者的预后较轻度患者差。

Objective To explore the prognosis including pulmonary function of patients with occupational asthma(OA),thereby provide some evidences for a scientific management of occupational asthma.Methods The data of 51 inpatients with occupational asthma in our hospital were collected,and the therapeutic regimen,effect and lung function status were analyzed retrospectively.All the patients were removed from their working posts and no longer exposed to asthma-causing substances after diagnosis.Results The results showed that during the follow-up period(1~9 years),there were 12 patients had been hospitalized for the acute attack of asthma.1 year after diagnosis and treatment,the asthma control level and score were all improved,while the therapeutic regimen was downgraded,FEV1.0and FEV1.0/FVC%were improved as well than that before treatment,the difference was significant(P<0.05),however,there was no significant difference in those changes mentioned above between the last and 1 year follow-up after treatment(P>0.05).Additionally,the pulmonary function indexes of moderate patients improved significantly at 1 year after the diagnosis compared with that at the time of diagnosis,especially FEV1.0 showed continuous improvement at the last follow-up(P<0.05).Conclusion It is suggested that most OA patients have a better prognosis after timely termination of occupational hazard exposure and acception of individualized treatment,but the prognosis of moderate OA was poorer than that of mild OA.