Airway distensibility in adults with asthma and healthy adults, measured by forced oscillation technique
Airway distensibility in adults with asthma and healthy adults, measured by forced oscillation technique
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DOI：
10.1164/rccm.200609-1317oc
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发表时间：
2007-07-15
影响因子：
24.7
通讯作者：
King, Gregory G.
中科院分区：
文献类型：
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作者：
Brown, Nathan.;Salome, Cheryl M.;King, Gregory G.
理由：与对照受试者相比，哮喘受试者气道扩张性降低可能与肺弹性回缩和支气管运动张力的差异有关。目的：检查肺弹性回缩和支气管运动张力对气道扩张性的贡献。方法：我们比较了 18 名哮喘受试者与 19 名对照受试者在支气管扩张剂给药前后的气道扩张性，并且在由 7 名哮喘受试者和 8 名对照受试者组成的亚组中，将扩张性相关联测量和主要结果： 使用受迫振荡技术测量扩张性，作为总肺活量 (TLC) 和 75% TLC 之间以及 75% TLC 和 FRC 之间电导与体积的线性斜率。使用食管球囊同时记录跨肺压和扩张性。使用线性回归描述压力-电导数据，使用指数方程描述压力-体积数据。与对照受试者相比，哮喘受试者的基线 FEV1 (p = 0.0003) 和电导 (p = 0.002) 较低。哮喘受试者中高于 75% TLC 的扩张性低于对照组 (p < 0.0001)，但低于 75% TLC 则没有差异。尽管哮喘受试者的 FEV1 (p = 0.0002) 和电导 (p < 0.0001) 以及对照受试者的电导 (p < 0.0004) 有所增加，但服用支气管扩张剂并没有改变扩张性。给予支气管扩张剂后，与对照组相比，哮喘受试者的肺弹性回缩力降低（p = 0.03），压力-电导斜率降低（p = 0.01），但压力-容量特征与气道扩张性之间没有相关性。 结论：与非哮喘受试者相比，哮喘受试者通过强迫振荡技术测量的气道扩张性降低，与肺弹性回缩力无关，并且支气管扩张剂给药后气道扩张性没有变化。气道壁重塑仍然是哮喘气道扩张性降低的最可能原因。
Rationale: Reduced airway distensibility in subjects with asthma compared with control subjects may be related to differences in lung elastic recoil and bronchomotor tone.Objectives: To examine the Contribution of lung elastic recoil and bronchomotor tone to airway distensibility.Methods: We compared airway distensibility in 18 subjects with asthma with 19 control subjects before and after bronchodilator administration and, in a subgroup of 7 subjects with asthma and 8 control subjects, correlated distensibility with pressure-volume parameters.Measurements and Main Results: Distensibility was measured, using the forced oscillation technique, as the linear slope of conductance versus volume between total lung capacity (TLC) and 75% TLC and between 75% TLC and FRC. Transpulmonary pressure was recorded concurrently with distensibility, using an esophageal balloon. Pressure-conductance data were described using linear regressions and pressure-volume data were described using exponential equations. Subjects with asthma had lower baseline FEV1 (p = 0.0003) and conductance (p = 0.002) than did control subjects. Distensibility above 75% TLC was less in subjects with asthma than in control subjects (p < 0.0001), but there was no difference below 75% TLC. Bronchodilator administration did not alter distensibility despite increases in FEV1 (p = 0.0002) and conductance (p < 0.0001) in subjects with asthma, and Conductance (p 0.0004) in control subjects. After bronchodilator administration, subjects with asthma had reduced lung elastic recoil compared with control subjects (p = 0.03) and a reduced pressure-conductance slope (p = 0.01), but there were no correlations between pressure-volume characteristics and airway distensibility.Conclusions: Airway distensibility measured by forced oscillation technique is reduced in subjects with asthma compared with subjects without asthma, is not related to lung elastic recoil, and is unchanged by bronchodilator administration. Airway wall remodeling remains the most likely cause of reduced airway distensibility in asthma.