Kiyokawa H, Yonemaru M, Horie S, Kasuga I, Ichinose Y, Toyama K
First Department of Internal Medicine, Tokyo Medical University, Japan.
Respirology. 1999 Mar;4(1):37-45. doi: 10.1046/j.1440-1843.1999.00150.x.
Common clinical features of bronchial asthma include bronchoconstriction during the night, particularly while asleep. Although bronchoconstriction reduces the quality of life and can cause life-threatening events, a clinical technique for evaluating bronchoconstriction during sleep has not been widely applied. In this study, we measured nocturnal wheezing by intermittent sleep tracheal sounds recording (ISTSR) to detect bronchoconstriction during the hours of sleep. Using ISTSR, we studied the number and duration of nocturnal wheezing episodes in 27 adult patients with bronchial asthma. Nocturnal wheezing was detected in 36 of 39 recordings. Although the pattern of hourly nocturnal wheezing count (hourly NWC pattern) varied among subjects, there appeared to be a reproducible pattern within individuals. When wheezing alternated between long and short duration, bronchoconstriction tended to be more severe. The NWC in 1 h (NWC/H) was positively correlated with subjective symptoms and inversely correlated with the morning per cent peak expiratory flow. The hourly NWC was significantly greater at 05:00 than that at midnight. Intermittent sleep tracheal sounds recording has potential to be a non-invasive clinical tool for detecting nocturnal bronchoconstriction during hours of sleep in patients with asthma.
支气管哮喘的常见临床特征包括夜间支气管收缩,尤其是在睡眠期间。尽管支气管收缩会降低生活质量并可能导致危及生命的事件,但一种评估睡眠期间支气管收缩的临床技术尚未得到广泛应用。在本研究中,我们通过间歇性睡眠气管声音记录(ISTSR)来测量夜间哮鸣音,以检测睡眠期间的支气管收缩。使用ISTSR,我们研究了27名成年支气管哮喘患者夜间哮鸣音发作的次数和持续时间。在39次记录中有36次检测到夜间哮鸣音。尽管各受试者每小时夜间哮鸣音计数模式(每小时NWC模式)有所不同,但个体内部似乎存在可重复的模式。当哮鸣音在长时和短时之间交替时,支气管收缩往往更严重。1小时内的NWC(NWC/H)与主观症状呈正相关,与早晨呼气峰值流速百分比呈负相关。05:00时的每小时NWC显著高于午夜时。间歇性睡眠气管声音记录有可能成为一种用于检测哮喘患者睡眠期间夜间支气管收缩的非侵入性临床工具。