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阻塞性肺疾病中支气管收缩的感知(疾病特异性呼吸困难)。

Perception of bronchoconstriction in obstructive pulmonary diseases (disease-specific dyspnoea).

作者信息

Ekici Aydanur, Yilmaz Sevda, Ekici Mehmet, Kalpaklioğlu Füsun, Karadeniz Yasemin, Arslan Mesut, Iteginli Ahmet, Kara Turkan, Kurtipek Ercan

机构信息

Department of Pulmonary Medicine, Kirikkale University Faculty of Medicine, 71100 Kirikkale, Turkey.

出版信息

Clin Sci (Lond). 2003 Aug;105(2):181-5. doi: 10.1042/CS20020364.

Abstract

The perception of dyspnoea differs between subjects with obstructive pulmonary diseases, partly because the underlying mechanisms for bronchoconstriction are different. We investigated the perception of bronchoconstriction in subjects with bronchiectasis, asthma and chronic bronchitis and possible contributing factors. Forty-seven non-smoking subjects with bronchiectasis, 50 subjects with asthma and 31 with chronic bronchitis were challenged with histamine. The Borg score was assessed before and after each challenge. The perception score corresponding to a fall in the forced expiratory volume in 1 s (FEV(1)) by 20% (PS(20)) was calculated. The mean values of DeltaBorg/DeltaFEV(1) (the Borg score change divided by the change in FEV(1) as a percentage of the baseline FEV(1)) and PS(20) of subjects with bronchiectasis and chronic bronchitis were significantly lower than in subjects with asthma after histamine challenge. The ratio of non-perceivers was higher in bronchiectasis (25.5%) and in chronic bronchitis (32.3%) than in asthma (4.0%). When all subjects were considered, DeltaBorg/DeltaFEV(1) values were significantly related to female sex ( r (2)=11.5%, P =0.0001), but not to age, duration of the disease, PD(20) or baseline FEV(1)%. The present study indicates that perception of histamine-induced bronchoconstriction is lower in patients with bronchiectasis and chronic bronchitis than in asthmatic patients, and that sex partially contributes to this difference.

摘要

阻塞性肺疾病患者对呼吸困难的感知存在差异,部分原因是支气管收缩的潜在机制不同。我们调查了支气管扩张症、哮喘和慢性支气管炎患者对支气管收缩的感知及可能的影响因素。47名非吸烟支气管扩张症患者、50名哮喘患者和31名慢性支气管炎患者接受了组胺激发试验。每次激发试验前后评估Borg评分。计算1秒用力呼气容积(FEV(1))下降20%时对应的感知评分(PS(20))。组胺激发试验后,支气管扩张症和慢性支气管炎患者的DeltaBorg/DeltaFEV(1)(Borg评分变化除以FEV(1)相对于基线FEV(1)的变化百分比)和PS(20)的平均值显著低于哮喘患者。支气管扩张症(25.5%)和慢性支气管炎(32.3%)中无感知者的比例高于哮喘(4.0%)。在所有受试者中,DeltaBorg/DeltaFEV(1)值与女性显著相关(r(2)=11.5%,P =0.0001),但与年龄、病程、PD(20)或基线FEV(1)%无关。本研究表明,支气管扩张症和慢性支气管炎患者对组胺诱导的支气管收缩的感知低于哮喘患者,且性别在一定程度上导致了这种差异。

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