Ringsberg K C, Akerlind I
Department of Health and Environment, Division for Preventive and Social Medicine and Public Health Science, Linköpings Universitet, Linköping, Sweden.
J Allergy Clin Immunol. 1999 Apr;103(4):601-8. doi: 10.1016/s0091-6749(99)70231-9.
A group of patients reporting asthma-like symptoms but with negative asthma tests has been identified.
The objective of this study was to determine whether hyperventilation might explain these symptoms and whether the tests could be used as diagnostic tools.
A hyperventilation provocation test (HVPT), a mental stress test, and the Word Color Conflict Test (WCCT) were performed on 10 patients with asthma-like symptoms, 10 patients with asthma, and 10 healthy subjects. End-tidal PCO 2 (PETCO2) was recorded 10 minutes after the HVPT and during the WCCT. Blood pressure, heart rate, and respiratory rate were also studied. The Nijmegen symptom questionnaire was used in the assessment of symptoms.
After the HVPT, the PETCO2 values recovered most slowly in the study group, the difference being significant compared with the healthy group (P <.01). During the WCCT, the study group had the lowest PETCO2 values at the 10- and 15-minute measurements, the difference again being significant compared with the healthy group (P <.05). The study group more often experienced symptoms before the test than the group with asthma (P <.05) and the healthy group (P <.001). The study group recognized significantly more symptoms previously experienced during the HVPT than the group with asthma (P <.05) and the healthy group (P <.01) and during the WCCT than the healthy group (P <.05). The study group showed a negative correlation between the PETCO2 level and the number of symptoms after the HVPT at 8 (r = -0-72; P <.05) and 10 minutes (r = -0.76; P <.05) and after the WCCT (r = -0.59; P <.05). Blood pressure, heart rate, and respiratory rate showed small differences between the groups.
Patients with asthma-like symptoms may experience hyperventilation when provoked. Mental stress might be 1 trigger factor. The HVPT and WCCT can be used as diagnostic instruments.
已识别出一组报告有哮喘样症状但哮喘检测呈阴性的患者。
本研究的目的是确定过度通气是否可以解释这些症状，以及这些检测是否可作为诊断工具。
对10名有哮喘样症状的患者、10名哮喘患者和10名健康受试者进行过度通气激发试验（HVPT）、心理应激试验和文字颜色冲突试验（WCCT）。在HVPT后10分钟以及WCCT期间记录呼气末二氧化碳分压（PETCO2）。还研究了血压、心率和呼吸频率。使用奈梅亨症状问卷评估症状。
HVPT后，研究组的PETCO2值恢复最慢，与健康组相比差异有统计学意义（P<.01）。在WCCT期间，研究组在10分钟和15分钟测量时的PETCO2值最低，与健康组相比差异再次有统计学意义（P<.05）。研究组在试验前比哮喘组（P<.05）和健康组（P<.001）更常出现症状。研究组在HVPT期间比哮喘组（P<.05）和健康组（P<.01）以及在WCCT期间比健康组（P<.05）能明显识别出更多之前经历过的症状。研究组在HVPT后8分钟（r = -0.72；P<.05）和10分钟（r = -0.76；P<.05）以及WCCT后（r = -0.59；P<.05），PETCO2水平与症状数量之间呈负相关。各组之间血压、心率和呼吸频率差异较小。
有哮喘样症状的患者在受到激发时可能会出现过度通气。心理应激可能是一个触发因素。HVPT和WCCT可作为诊断工具。
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