Erhan TURGUT, Ahmet AKKAYA, Mehmet ÜNLÜ, Ünal ŞAHİN

Menstrüel siklusun astma alevlenmesi üzerine etkisi

Bu çalışmanın amacı, astma hastalarında menstrüel siklus ile astma alevlenmesi arasındaki ilişkiyi araştırmaktır. Çalışmaya hafif ve orta astması olan 95 hasta alınmıştır. Olguların yaş ortalaması 26.87 ± 6.18 olarak saptanmıştır. Hastalar astma ve menstrüel siklus ilişkisini gösteren soruları içeren anket formunu doktor eşliğinde doldurmuşlardır. Menstrüel siklus; premenstrüel dönem (adetten önceki 7 günlük süre), menstrüel dönem ve siklus ortası dönem olmak üzere başlıca 3 dönem altında incelenmiştir. On hastada (%10.52) prementsrüel dönemde astma yakınmalarında şiddetlenme olduğu tespit edilmiştir. Bu hastaların 7'sinde yakınmalar menstrüel dönemde de devam etmiştir. Kontrol altında olan 85 hastanın 13'ünün ve premenstrüel yakınması olan 10 olgunun tamamının 3 ay boyunca günde 2 kez olacak şekilde zirve akım hız (ZAH)'ları ölçülmüştür. Olgu grubundaki hastaların premenstrüel ve intramenstrüel dönemdeki ortalama ZAH değerleri siklus ortası değerlerden anlamlı olarak düşük bulunmuştur. Önceki çalışmalar astmalı kadınların %17-40'ında premenstrüel dönemde astma yakınmalarında alevlenme olduğunu gösterirken, bizim çalışmamızda bu oranın %10.52 ile daha düşük düzeylerde olduğu saptanmıştır.

Effects of the menstrual cycle on asthma exacerbation

The purpose of this study was to determine whether a relationship exists between phases of the menstruel cycle and asthma exacerbations in adult females. The study population was comprised of 95 out-patient women with stable mild to moderate asthma. The mean age was 26.87. The patients completed an interviewer-administered standardized questionnaire concerning the relationship between their asthma and the menstrual cycle. The menstrual cycle was divided into 3 phases; premenstrual phase (the seven days preceding the menstrual period), intramenstrual phase and mid-cycle phase. Ten patients (10.52%) had subjective perception of deterioration in symptoms of asthma in premenstrual phase. In 7 of these 10 patients, this phenomenon continued to occur during the menstrual week also. Thirteen of 85 asymptomatic patients and all the symptomatic patients in premenstrual period (n:10) were also administered a daily peak expiratory flow rate (PEFR) diary for 3 consecutive menstrual cycles. The mean PEFR values over 3 cycles revealed a significant fall in the morning as well as evening values in the premenstrual and menstrual periods in comparison to the mid-cycle period in patients with menstrual-linked asthma. While previous studies revealed a premenstrual increase of symptoms in 17-40 % of asthmatic patients, the ratio of PMA was lower (10.52%) in our patients.

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