Heroin insufflation as a trigger for patients with life-threatening asthma
Heroin insufflation as a trigger for patients with life-threatening asthma
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DOI：
10.1378/chest.123.2.510
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发表时间：
2003-02-01
期刊：
影响因子：
9.6
通讯作者：
Hryhorczuk, DO
中科院分区：
文献类型：
--
作者：
Krantz, AJ;Hershow, RC;Hryhorczuk, DO
研究目的：确定市中心因危及生命的哮喘而接受治疗的患者中自我报告的海洛因相关哮喘症状的患病率，并比较 ICU 哮喘患者和 ICU 对照糖尿病酮症酸中毒 (I)KA) 患者的药物使用率。 设计：研究 1 是因哮喘需要入住 ICU 的患者的连续病例系列（1999 年 1 月至 6 月）。研究 2 是一项回顾性病例对照研究，涉及需要 ICU 护理的哮喘患者和患有 DKA 的对照受试者（1997 年至 1998 年）。地点：市中心，公立医院 ICU。患者：1999 年 1 月至 6 月入住 ICU 的 23 名哮喘患者（26 名 ICU 入院者）（年龄范围，16 至 50 岁），以及 84 名患者（104 名 ICU 入院者）患有哮喘和 1997 年至 1998 年间，42 名 DKA 患者（年龄范围为 15 至 50 岁）入住 ICU。研究结果：自我报告的海洛因相关哮喘加重、海洛因或可卡因使用史以及尿液药物筛查 (UDS) 结果。测量和结果：在连续入住 ICU 的过程中，23 名患者中有 13 名 (56%) 描述了与海洛因相关的哮喘加重充气。在病例对照研究中，与 DKA 受试者相比，哮喘患者报告海洛因使用的可能性显着更高（41.3% vs 12.5%；p = 0.006），并且 UDS 结果阿片类阳性的患病率显着更高（60% vs：7%；p = 0.001）。根据病史和 UDS 结果计算的可卡因使用率在两组之间没有显着差异。结论：至少自 1997 年以来，海洛因注入是该市中心 ICU 中常见的哮喘触发因素，在危及生命的哮喘患者的护理中应予以考虑。
Study objectives: To determine the prevalence of self-reported, heroin-associated asthma symptoms among inner-city patients treated for life-threatening asthma, and to compare the rates of drug use between ICU patients with asthma and ICU control patients with diabetic ketoacidosis (I)KA).Designs: Study 1 was a sequential case series of patients requiring ICU admission for asthma (January to June 1999). Study 2 was a retrospective, case-control study of drug use among asthma patients and control subjects with DKA requiring ICU care (1997 to 1998).Setting: Inner-city, public hospital ICU.Patients: Twenty-three patients (26 ICU admissions) with asthma (age range, 16 to 50 years) admitted to the ICU from January to June 1999, and 84 patients (104 ICU admissions) with asthma and 42 patients with DKA (age range, 15 to 50 years) admitted to the ICU during 1997 to 1998.Outcomes studied: Self-reported, heroin-associated exacerbations, history of heroin or cocaine use, and urine drug screen (UDS) results.Measurements and results: in the sequential ICU admissions, 13 of 23 patients (56%) described asthma exacerbations associated with heroin insufflation. In the case-control study, asthmatics were significantly more likely to report heroin use (41.3% vs 12.5%; p = 0.006) and had a significantly higher prevalence of UDS results positive for opiates (60% vs: 7%; p = 0.001) compared to subjects with DKA. The rates of cocaine use by history and UDS results did not differ significantly between the two groups. Conclusions: At least since 1997, heroin insufflation is a common asthma trigger in this inner-city ICU and should be considered in the care of patients with life-threatening asthma.