Influence of posture on expiratory flows and airway responsiveness to methacholine in asthma.
Influence of posture on expiratory flows and airway responsiveness to methacholine in asthma.
复制标题
姿势对哮喘呼气流量和气道对乙酰甲胆碱反应性的影响。
作者：
M. Tahan;L. Boulet
这项研究着眼于姿势对早晚呼气流量和气道对甲胆碱反应的影响。14名不吸烟的稳定哮喘患者（8名男性，6名女性）被纳入研究。受试者被随机分配在不同的天中，早上8点至12点，晚上8点至12点，以仰卧或坐姿的方式度过4小时。在指定位置每小时测量一次FEV1。每4 h前后分别进行坐位甲胆碱吸入试验。在早晨的研究中，仰卧和坐姿的基线FEV1测量值没有差异。两日内基线和术后FEV1无显著差异（基线和术后fev1%预测+/- SEM；坐位：83.6 +/- 2.9,83.8 +/- 3.3；仰卧：85.8 +/- 2.8,85.4 +/- 3.7;n = 13）。δ FEV1（基线/会话后）在两个会话之间没有差异。在晚上的研究中，仰卧和坐着时的基线FEV1测量值相似。两组睡眠后FEV1均下降，尽管这种差异仅在仰卧位上具有统计学意义（基线和会后fev1%预测+/- SEM；坐姿：90.0 +/- 4.1,84.9 +/- 4.1,p = 0.08；仰卧位：90.7 +/- 3.1,82.9 +/- 4.5,p = 0.02; n = 8）。两组晚上的δ FEV1（基线/会后）无差异。上午，坐位后PC20甲胆碱保持不变（平均PC20 [mg/ml]：开始= 1.00，结束= 1.02），仰卧位后PC20甲胆碱从平均0.97降至0.73 mg/ml。最后一种降低主要发生在高反应性受试者中，其幅度与基线PC20显著相关（r = 0.637, p = 0.024）。仰卧后甲胆碱反应（δ PC20）的增加明显高于坐位后。在晚间研究中，两组患者的PC20均有轻微下降，但仅在仰卧位后才显著（平均PC20基线和会后[mg/ml]：坐位：0.63、0.47,p = 0.08；仰卧位：0.62、0.44,p = 0.04）。两个时段的δ PC20无差异。我们得出的结论是，仰卧位对FEV1没有持久的影响，但它可能会增加大多数高反应性受试者的气道反应性。
This study looked at the effects of posture on the morning/evening expiratory flows and airway responsiveness to methacholine. Fourteen nonsmoking subjects with stable asthma (eight men, six women) were included in the study. Subjects were randomly allocated to spend 4 h in the supine or seated position on separate days, in the morning from 8 to 12 AM and in the evening from 8 to 12 PM. The FEV1 was measured hourly in the assigned position. Before and after each 4-h period, a methacholine inhalation test was done in the sitting position. In the morning study, baseline FEV1 measurements on the supine and seated days were not different. There was no significant difference between the baseline and postsession FEV1 on both days (baseline and postsession FEV1 percent predicted +/- SEM; seated: 83.6 +/- 2.9, 83.8 +/- 3.3; supine: 85.8 +/- 2.8, 85.4 +/- 3.7; n = 13). delta FEV1 (baseline/postsession) was not different between the two sessions. In the evening study, baseline FEV1 measurements on the supine and seated days were similar. FEV1 decreased after both sessions, although this difference reached statistical significance only in the supine position (baseline and postsession FEV1 percent predicted +/- SEM; seated: 90.0 +/- 4.1, 84.9 +/- 4.1, p = 0.08; supine: 90.7 +/- 3.1, 82.9 +/- 4.5, p = 0.02; n = 8). delta FEV1 (baseline/postsession) was not different between the two evening sessions. In the morning, after the seated position, PC20 methacholine was unchanged (mean PC20 [mg/ml]: beginning = 1.00, end = 1.02) while after the supine position it was slightly reduced from a mean of 0.97 to 0.73 mg/ml. This last reduction was mainly observed in the most hyperresponsive subjects and its magnitude was significantly correlated with baseline PC20 (r = 0.637, p = 0.024). The increase in methacholine response (delta PC20) after the supine session was significantly higher than after the seated session. In the evening study, there was a slight reduction in PC20 after both sessions, but this was only significant after the supine position (mean PC20 baseline and postsession [mg/ml]: seated: 0.63, 0.47, p = 0.08; supine: 0.62, 0.44, p = 0.04). No difference was found between delta PC20 of the two sessions. We conclude that the supine position does not have persistent effects on FEV1, but it may increase airway responsiveness in the most hyperreactive subjects.
呼气峰流速每日变化的正常范围。
DOI：
10.1164/ajrccm/143.2.323
发表时间：
1991
期刊：
The American review of respiratory disease
影响因子：
--
作者：
Quackenboss,JJ;Lebowitz,MD;Krzyzanowski,M
通讯作者：
Krzyzanowski,M
DOI：
10.1164/ajrccm/143.2.351
发表时间：
1991-02-01
期刊：
AMERICAN REVIEW OF RESPIRATORY DISEASE
影响因子：
--
作者：
MARTIN, RJ;CICUTTO, LC;SZEFLER, SJ
通讯作者：
SZEFLER, SJ