Deep inspiration-induced changes in lung volume decrease with severity of asthma.
Deep inspiration-induced changes in lung volume decrease with severity of asthma.
复制标题
深吸气引起的肺容量变化随着哮喘的严重程度而减少。
DOI：
10.1016/j.rmed.2006.09.009
复制
发表时间：
2007
影响因子：
4.3
通讯作者：
Bellia,Vincenzo
中科院分区：
文献类型：
--
作者：
Scichilone,Nicola;Marchese,Roberto;Soresi,Simona;Interrante,Amelia;Togias,Alkis;Bellia,Vincenzo
我们之前曾报道过，与健康受试者相比，轻度哮喘患者深吸气 (DI) 引起的支气管扩张程度仅略有降低。本研究的目的是评估哮喘严重程度的增加是否与 DI 引起肺容量变化的能力受损有关。根据 GINA 指南，从巴勒莫大学呼吸疾病研究所肺科和过敏门诊诊所连续招募的 36 名哮喘患者被分为 3 组：间歇性 (I)、轻度持续性 (MP) 和中度至重度 (MS)。在没有 DI 的情况下进行单剂量乙酰甲胆碱 (Mch) 支气管激发，以诱导吸气肺活量 (IVC) 较基线至少减少 15%。 Mch 后 IVC 后进行 4 次连续 DI 和另一次 IVC，以确定 DI 的支气管扩张作用。 DI 的支气管扩张作用随着哮喘严重程度的增加而显着降低（I：68±5.4%，MP：45±7.2%，MS：4±15.6%；方差分析：P<0.0001）。 DI（而非 FEV1 或 FEV1/FVC）引起的支气管扩张也与症状评分（r=-0.42，P=0.01）和每周沙丁胺醇使用量（r=-0.47，P=0.004）呈负相关。这些观察结果支持了这样的假设：DI 的支气管扩张作用的减弱导致哮喘临床表现的严重程度。
We have previously reported that the magnitude of deep inspiration (DI)-induced bronchodilation is only slightly reduced in mild asthmatics, compared to healthy subjects. The aim of this study was to evaluate whether increased severity of asthma is associated with impairment in the ability of DI to induce changes in lung volume. Thirty-six consecutive asthmatics recruited from the Pulmonary and the Allergy Outpatient Clinics of the Institute of Respiratory Diseases of the University of Palermo were divided into 3 groups: Intermittent (I), Mild Persistent (MP) and Moderate–Severe (MS), based on GINA guidelines. Single dose methacholine (Mch) bronchoprovocations were performed in the absence of DI, to induce at least 15% reduction in inspiratory vital capacity (IVC) from baseline. The post-Mch IVC was followed by 4 consecutive DI and by another IVC, to determine the bronchodilatory effect of DI. The bronchodilatory effect of DI was found to significantly decrease with increasing severity of asthma (I: 68±5.4%, MP: 45±7.2%, MS: 4±15.6%; ANOVA: P<0.0001). Bronchodilation by DI, but not FEV1or FEV1/FVC, was also inversely correlated to symptom scores (r=-0.42, P=0.01) and to weekly salbutamol usage (r=-0.47, P=0.004). These observations provide support to the hypothesis that the attenuation of the bronchodilatory effect of DI contributes to the severity of the clinical manifestations of asthma.