Alteration of the Circadian Rhythm in Peak Expiratory Flow of Nocturnal Asthma Following Nighttime Transdermal β2‐adrenoceptor Agonist Tulobuterol Chronotherapy
Alteration of the Circadian Rhythm in Peak Expiratory Flow of Nocturnal Asthma Following Nighttime Transdermal β2‐adrenoceptor Agonist Tulobuterol Chronotherapy
复制标题
夜间透皮 β2 肾上腺素受体激动剂妥洛特罗计时疗法后夜间哮喘呼气峰流量昼夜节律的改变
DOI：
10.1081/cbi-200053587
复制
发表时间：
2005
影响因子：
2.8
通讯作者：
E. Shimizu
中科院分区：
文献类型：
--
作者：
N. Burioka;M. Miyata;Masahiro Endo;Y. Fukuoka;H. Suyama;H. Nakazaki;K. Igawa;E. Shimizu
我们研究了夜间透皮疗法(β-2-肾上腺素能受体激动剂)对夜间哮喘的疗效，方法是评估症状频率和最大呼气流量昼夜节律的变化，最大呼气流量是衡量呼吸道口径的指标。对13例夜间哮喘患者在涂片计时治疗前和治疗中进行评估，每日1次，晚上1次，连续6天。患者在03：00~23：00之间每隔4h记录一次PEF，共1d。对PEF的昼夜节律进行分组均值余弦分析。应用计时疗法前，哮喘不稳定、夜间症状多发的2 4h最差时间--03：00h的平均PEF为2 76±4 5 L/min。夜间应用吐洛特罗贴剂后，03：00h组平均每分钟用力呼气量为363±67 L/分，与对照组比较差异有统计学意义(P<0.001)。在研究期间，当夜间症状频繁时，以及使用妥洛特罗贴片时，观察到明显的PEF昼夜节律。治疗前，PEF的潜伏期(昼夜节律的谷值时间)缩窄至04：00h左右，昼夜节律波幅为28.8 L/min。对照组昼夜节律幅度显著降低(P<0.01)，至10.4 L/分钟，24小时平均PEF显著升高。这些变化表明，在24小时内，吐洛特罗计时疗法显著提高了气道功能的水平和稳定性。夜间应用与不使用吐洛特罗贴剂治疗后，PEF的昼夜节律随哮喘症状的严重程度和频率而不同。我们的结论是，PEF的昼夜节律参数在确定夜间哮喘时辰疗法的必要性和有效性方面都是有用的。
We investigated the efficacy of nighttime transdermal tulobuterol (β2‐adrenoceptor agonist) chronotherapy for nocturnal asthma by assessing changes both in the frequency of symptoms and features of the circadian rhythm in peak expiratory flow (PEF), a measure of airway caliber. Thirteen patients with nocturnal asthma were evaluated before and during tulobuterol patch chronotherapy, applied once daily in the evening for 6 consecutive days. Patients were asked to record their PEF every 4 h between 03:00 and 23:00 h for one day. Circadian rhythms in PEF were examined by group‐mean cosinor analysis. The group average PEF at 03:00 h, the time during the 24 h when PEF is generally the poorest, before the application of the chronotherapy, when asthma was unstable and nocturnal symptoms frequent, was 276±45 L/min. Application of the tulobuterol patch at nighttime significantly increased (p<0.001) the 03:00 h group average PEF to 363±67 L/min. Significant circadian rhythms in PEF were observed during the span of study when nocturnal symptoms were frequent as well as with the use of the tulobuterol patch. Before the initiation of tulobuterol chronotherapy, the bathyphase (trough time of the circadian rhythm) in PEF narrowed to around 04:00 h, and the group circadian amplitude was 28.8 L/min. In contrast, the group circadian amplitude significantly (p<0.01) decreased to 10.4 L/min, and the 24 h mean PEF increased significantly with tulobuterol patch chronotherapy. These changes indicate that tulobuterol chronotherapy significantly increased both the level and stability of airway function over the 24 h. The circadian rhythm in PEF varied with the severity and frequency of asthmatic symptoms with and without the nighttime application of the tulobuterol patch medication. We conclude that the parameters of the circadian rhythm of PEF proved useful both in determining the need for and effectiveness of tulobuterol chronotherapy for nocturnal asthma.
影响因子：
2.8
作者：
Jarjour, NN
通讯作者：
Jarjour, NN