Obesity, expiratory flow limitation and asthma symptoms
Obesity, expiratory flow limitation and asthma symptoms
复制标题
DOI：
10.1016/j.pupt.2012.05.004
复制
发表时间：
2013-08-01
影响因子：
3.2
通讯作者：
Salome, Cheryl M.
中科院分区：
文献类型：
--
作者：
Mahadev, Sriram;Farah, Claude S.;Salome, Cheryl M.
肥胖与哮喘控制不良有关，但原因尚不清楚。如肥胖症中发生的操作肺容量的减少和如哮喘中发生的支气管收缩可增加潮式呼吸（EFLt）期间的呼气流量限制，这可进而增加呼吸症状。本研究的目的是确定肥胖对非哮喘和哮喘受试者基线和支气管收缩后EFLt的影响，并确定EFLt与呼吸道症状之间的相关性。使用由强迫振荡技术测量的呼吸系统电抗得出的EFLt指数，对先前发表的非哮喘和哮喘受试者研究的数据进行重新分析。分析表明，在支气管收缩期间，非哮喘和哮喘肥胖个体比非肥胖受试者更容易发生EFLt，尽管FEV1的变化相似。此外，EFLt指数是非哮喘受试者激发期间呼吸困难严重程度的重要决定因素，也是抗炎治疗后哮喘受试者哮喘症状控制的重要决定因素。这些研究表明，支气管收缩和低静息肺容量的组合增加了EFLt的风险，并且这种对支气管收缩的反应改变可能增加症状的严重程度并导致哮喘控制恶化。(c)2012爱思唯尔有限公司保留所有权利。
Obesity is associated with poor asthma control, but the reason for this is unclear. Reduction in operating lung volume, as occurs in obesity, and bronchoconstriction, as occurs in asthma, can increase expiratory flow limitation during tidal breathing (EFLt), which may in turn increase respiratory symptoms. The aim of this study was to determine the effect of obesity on EFLt at baseline and after bronchoconstriction in non-asthmatic and asthmatic subjects, and to determine the association between EFLt, and respiratory symptoms. Data from previously published studies in non-asthmatic and asthmatic subjects were reanalyzed using an index of EFLt derived from respiratory system reactance measured by the forced oscillation technique. The analysis showed that during bronchoconstriction both non-asthmatic and asthmatic obese individuals were more likely to develop EFLt than non-obese subjects, despite similar changes in FEV1. Furthermore the index of EFLt was a significant determinant of the severity of breathlessness during challenge in non-asthmatic subjects, and of asthma symptom control in asthmatic subjects following anti-inflammatory treatment. These studies suggest that the combination of bronchoconstriction and low resting lung volume increase the risk of EFLt, and that this altered response to bronchoconstriction may increase the severity of symptoms and lead to worse asthma control. (c) 2012 Elsevier Ltd. All rights reserved.