Characteristics of impaired voluntary cough function in individuals with amyotrophic lateral sclerosis.
Characteristics of impaired voluntary cough function in individuals with amyotrophic lateral sclerosis.
复制标题
肌萎缩侧索硬化症患者自主咳嗽功能受损的特征。
DOI：
10.1080/21678421.2018.1510011
复制
发表时间：
2019
影响因子：
2.8
通讯作者：
Plowman,EmilyK
中科院分区：
文献类型：
--
作者：
Tabor-Gray,LaurenC;Gallestagui,Alessandra;Vasilopoulos,Terrie;Plowman,EmilyK
目的：虽然咳嗽障碍（吞咽困难）在肌萎缩侧索硬化（ALS）患者中很常见，并导致保护气道的生理能力降低，但吞咽困难的特征尚未得到描述。因此，我们的目的是比较自愿咳嗽肺功能测定气流模式与ALS和健康的年龄和性别匹配controls.Methods：32个人诊断的可能明确的ALS（埃尔埃斯科里亚尔标准）和29个健康的年龄和性别匹配的对照进行自愿咳嗽肺功能测定测试。两个盲法评估者得出六个客观的自主咳嗽气流测量值，包括：峰值吸气相持续时间、峰值吸气流速、压缩相持续时间、峰值呼气上升时间、峰值呼气流速和咳嗽体积加速度。结果：与健康对照组相比，ALS患者在自主咳嗽过程中，吸气相和呼气相上升时间延长，吸气和呼气流速降低，咳嗽体积加速度降低（p <0.05）。结论：本研究比较了ALS患者与健康对照者的自主咳嗽气流模式的特征。研究结果表明，在吸气和呼气自主咳嗽气流的损伤，导致较慢，较弱，因此有效性较低的自主咳嗽产生ALS个人。这些数据提供了对ALS患者气道清除和分泌管理不足的生理学受损的深入了解。
Objective: Although cough impairment (dystussia) is common in individuals with amyotrophic lateral sclerosis (ALS) and contributes to a reduced physiologic capacity to defend the airway, characteristics of dystussia have not yet been delineated. Therefore, we aimed to compare voluntary cough spirometry airflow patterns between individuals with ALS and healthy age and gender-matched controls.Methods: Thirty-two individuals with a diagnosis of probable-definite ALS (El-Escorial Criterion) and 29 healthy age and gender-matched controls underwent voluntary cough spirometry testing. Two blinded raters derived six objective voluntary cough airflow measures including: peak inspiratory phase duration, peak inspiratory flow rate, compression phase duration, peak expiratory rise time, peak expiratory flow rate, and cough volume acceleration. Independent samplest-tests with Cohen’sdeffect sizes were performed between Healthy versus ALS groups for cough metrics (alpha =0.05).Results: ALS individuals demonstrated prolonged inspiratory phase and expiratory phase rise time durations, reduced inspiratory and expiratory flow rates, and lower cough volume acceleration during voluntary cough production compared with healthy controls (p <0.05). No differences in compression phase duration were observed (p >0.05).Conclusions: This study compared characteristics of voluntary cough airflow patterns of individuals with ALS to healthy-matched controls. Findings identified impairments in both inspiratory and expiratory voluntary cough airflow, resulting in slower, weaker, and thus less effectiveness voluntary cough production in ALS individuals. These data afford insight into the impaired physiology underlying inadequate airway clearance and secretion management in individuals with ALS.