Influence of the previous deep inspiration on the spirometric measurement of provoked bronchoconstriction in asthma.
Influence of the previous deep inspiration on the spirometric measurement of provoked bronchoconstriction in asthma.
复制标题
先前的深吸气对哮喘引起的支气管收缩的肺活量测量的影响。
DOI：
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发表时间：
2015
期刊：
影响因子：
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通讯作者：
A. Beaupré
中科院分区：
文献类型：
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作者：
J. Orehek;Nicoli Mm;S. Delpierre;A. Beaupré
最大吸气后一秒用力呼气量（FEV 1）的测量通常用于评估吸入支气管收缩剂的效果。在哮喘患者中，深吸气以可变的方式短暂地改变支气管张力。这可能会导致FEV 1的不同程度降低，尽管哮喘引起的支气管痉挛程度相似。在71例哮喘患者中，我们用雾化卡巴胆碱诱导了气道阻力（Raw）的可比增加（约200%）。然后，我们测量了一次深吸气引起的Raw变化;当Raw恢复到深吸气前观察到的值时，测量FEV 1。深吸气引起的Raw的瞬时变化（范围从33%增加到70%减少）与FEV 1的减少（从0到70%）之间存在显著相关性（r = 0.74; p <0.001）。深吸气增加Raw的患者FEV 1下降最大，而Raw下降的患者FEV 1下降最小。FEV 1降低小于20%的17例患者的初始和卡巴胆碱给药后原始值与FEV 1降低超过20%的54例患者相似。因为在某些哮喘患者中，预先深吸气会阻止FEV 1的变化，所以使用FEV 1进行支气管激发试验可能会产生误导。
The measurement of the forced expiratory volume in one second (FEV1) after a maximal inspiration is often used to assess the effect of inhaled bronchoconstrictor agents. In persons with asthma, a deep inspiration transiently alters the bronchial tone in a variable way. This may result in a variable decrease of FEV1 despite a similar degree of pharmacologically induced bronchospasm. In 71 patients with asthma we induced a comparable increase (approximating 200%) in airway resistance (Raw) with aerosolized carbachol. We then measured the change in Raw induced by one deep inspiration; when Raw had returned to the value observed before deep inspiration, the FEV1 was measured. A significant correlation (r = 0.74; p less than 0.001) was found between the transient changes in Raw induced by a deep inspiration (ranging individually from a 33% increase to a 70% decrease) and the decrease in FEV1 (from 0 to 70%). The decrease in FEV1 was greatest in patients in whom a deep inspiration increased Raw and least in those in whom Raw decreased. The initial and post-carbachol Raw values of the 17 patients exhibiting a less than 20% decrease in FEV1 were similar to those of the 54 patients with a decrease in FEV1 of more than 20%. Because a prior deep inspiration prevents changes in FEV1 in some patients with asthma, the use of the FEV1 for bronchial provocation tests can be misleading.