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运动诱发性支气管收缩患儿深吸气时的呼吸传导反应。

Respiratory conductance response to a deep inhalation in children with exercise-induced bronchoconstriction.

作者信息

Marchal François, Schweitzer Cyril, Khallouf Samih

机构信息

Service d'Explorations Fonctionnelles Pédiatriques, Hôpital d'Enfants, Centre Hospitalier Universitaire de Nancy, Vandoeuvre, France.

出版信息

Respir Med. 2003 Aug;97(8):921-7. doi: 10.1016/s0954-6111(03)00117-3.

Abstract

Airway response to deep inhalation (DI) may provide information relevant to the mechanisms of airway obstruction (AO). The hypothesis examined here is that DI provokes bronchodilation in children during exercise-induced bronchoconstriction (EIB). EIB was attested in 15 children aged 10+/-3 year (mean+/-SD) by a decrease in forced expiratory volume in 1 s (FEV1) > or = 15% from baseline after a free running test. The respiratory resistance was measured by the forced oscillation technique at 12 Hz using a head generator to vary transrespiratory pressure around the head. The airway response to DI was estimated by the effect on respiratory conductance (Grs), calculated as the reciprocal of respiratory resistance in inspiration. During EIB, DI induced a variable but significant increase in Grs, from 0.085+/-0.023 to 0.101+/-0.029 l hPa(-1) s(-1) (P = 0.0003). The post- to pre-DI Grs ratio (1.19+/-0.14) was found to correlate negatively with EIB-induced reduction in FEV1 (P = 0.02), forced vital capacity (FVC) (P = 0.01) but not FEV1/FVC, i.e., DI induced more bronchodilation in those children with small EIB associated reduction in FVC. It is concluded that the bronchodilator effect of DI may be demonstrated in children with EIB. It is suggested that the associated small airway closure and lung hyperinflation may contribute to limit this response to DI.

摘要

气道对深吸气(DI)的反应可能提供与气道阻塞(AO)机制相关的信息。此处检验的假设是,在运动诱发的支气管收缩(EIB)期间,DI可引起儿童支气管扩张。通过自由跑步试验后1秒用力呼气量(FEV1)较基线下降≥15%,证实15名年龄为10±3岁(均值±标准差)的儿童存在EIB。使用头部发生器在12Hz频率下通过强迫振荡技术测量呼吸阻力,以改变头部周围的跨呼吸压力。通过对呼吸传导率(Grs)的影响来评估气道对DI的反应,Grs计算为吸气时呼吸阻力的倒数。在EIB期间,DI使Grs出现了可变但显著的增加,从0.085±0.023升至0.101±0.029l hPa-1 s-1(P = 0.0003)。发现DI后与DI前的Grs比值(1.19±0.14)与EIB诱发的FEV1降低(P = 0.02)、用力肺活量(FVC)降低(P = 0.01)呈负相关,但与FEV1/FVC无关,即DI在那些EIB相关FVC降低较小的儿童中诱发了更多的支气管扩张。结论是,在患有EIB的儿童中可证实DI的支气管扩张作用。提示相关的小气道关闭和肺过度充气可能有助于限制对DI的这种反应。

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