Fujii H, Fukutomi O, Inoue R, Shinoda S, Okammoto H, Teramoto T, Kondo N, Wada H, Saito K, Matsuoka T, Seishima M
Department of Laboratory Medicine, Gifu University School of Medicine, Japan.
Ann Allergy Asthma Immunol. 2000 Sep;85(3):233-7. doi: 10.1016/S1081-1206(10)62472-6.
Bronchial asthma is associated with abnormal autonomic nervous function in childhood. Exercise is one of the most common precipitating factors of acute asthmatic crises although the exact mechanism of autonomic regulation in asthmatic children after exercise is unclear.
The aim of this study was to investigate the features of autonomic regulation after exercise in asthmatic and control children.
Pulmonary function tests and heart rate variability spectral analysis were performed in 15 asthmatic children and 7 control children (age 6 to 15 years) during and after an exercise challenge.
The maximum % fall of forced expiratory volume in 1 second (FEV1) was significantly greater (P < .01) in asthmatic subjects (9.1 +/- 5.1%) than in normal control subjects (1.0 +/- 2.5%). The high frequency band (HF) amplitude, an index of cardiac vagal tone, 5 minutes after exercise was significantly higher (P < .05) in the asthmatic subjects (14.4 +/- 7.9 msec) than in control subjects (5.9 +/- 2.6 msec). Furthermore, the difference in the HF amplitude between the control group and the exercise-induced asthma group was significant both 5 minutes (P < .01) and 10 minutes (P < .05) after challenge. There was a significant correlation (P = .565, P = .0165) between HF amplitude 5 minutes after exercise and the magnitude of the decrease in FEV1. On the other hand, no significant difference was observed in the low frequency band amplitude between the controls and the asthmatic subjects. The ratio of low frequency to high frequency power, which is suggested to correlate with cardiac sympathetic activity, did not differ between the two groups.
These findings suggest that autonomic nervous activities, particularly vagal response after exercise, in asthmatic children is different from that in control children.
支气管哮喘与儿童自主神经功能异常有关。运动是急性哮喘发作最常见的诱发因素之一,尽管运动后哮喘患儿自主神经调节的确切机制尚不清楚。
本研究旨在探讨哮喘患儿与对照儿童运动后自主神经调节的特点。
对15例哮喘患儿和7例对照儿童(年龄6至15岁)在运动激发试验期间及之后进行肺功能测试和心率变异性频谱分析。
哮喘患者一秒用力呼气量(FEV1)的最大下降百分比(9.1±5.1%)显著大于正常对照受试者(1.0±2.5%)(P<.01)。运动后5分钟,作为心脏迷走神经张力指标的高频段(HF)振幅,哮喘患者(14.4±7.9毫秒)显著高于对照受试者(5.9±2.6毫秒)(P<.05)。此外,激发试验后5分钟(P<.01)和10分钟(P<.05),对照组与运动诱发哮喘组之间的HF振幅差异均有统计学意义。运动后5分钟HF振幅与FEV1下降幅度之间存在显著相关性(P=.565,P=.0165)。另一方面,对照组与哮喘患者之间的低频段振幅未观察到显著差异。提示与心脏交感神经活动相关的低频与高频功率比值在两组之间无差异。
这些发现表明,哮喘患儿的自主神经活动,尤其是运动后的迷走神经反应,与对照儿童不同。