背景:海洛因的使用会导致呼吸道并发症,包括哮喘,慢性阻塞性肺疾病(COPD)和支气管扩张(BD)。
目的:介绍海洛因消费与支气管并发症关系的文献综述,同时强调诊断和管理的困难。
■Medline,1980-2022年,关键词“哮喘”或“支气管痉挛”或“COPD”或“支气管扩张”和“海洛因”或“阿片类药物”或“阿片类药物”,限制与“标题/摘要”有关。关于哮喘,纳入26项研究,COPD为16,BD为5。
结果:哮喘和COPD在海洛因成瘾者中更为普遍,与其他患者相比,他们的治疗依从性较低。作者发现哮喘发作频率之间存在正相关,入院重症监护和吸入海洛因。COPD的晚期诊断会使病程恶化;肺气肿和BD是预后不良的因素。
结论:海洛因使用者的支气管疾病可以通过呼吸功能探查和胸部CT扫描来识别。这些测试应该经常进行,以优化他们的护理,其中包括他们从成瘾物质中断奶。
BACKGROUND: Heroin use can cause respiratory complications including asthma, chronic obstructive pulmonary disease (COPD) and bronchiectasis (BD).
OBJECTIVE: A general review of the literature presenting the data on the relationships between heroin consumption and bronchial complications, while underlining the difficulties of diagnosis and management.
UNASSIGNED: Medline, 1980-2022, keywords \"asthma\" or \"bronchospasm\" or \"COPD\" or \"bronchiectasis\" and \"heroin\" or \"opiate\" or \"opiates\", with limits pertaining to \"Title/Abstract\". Concerning asthma, 26 studies were included, as were 16 for COPD and 5 for BD.
RESULTS: Asthma and COPD are more prevalent among heroin addicts, who are less compliant than other patients with their treatment. The authors found a positive association between frequency of asthma exacerbations, admission to intensive care and heroin inhalation. Late diagnosis of COPD worsens the course of the disease; emphysema and BD are poor prognostic factors.
CONCLUSIONS: Bronchial diseases in heroin users can be identified by means of respiratory function exploration and chest CT scans. These tests should be performed frequently in view of optimizing their care, which includes their weaning themselves from addictive substances.