Martínez-Moragón E, Perpiñá M, Belloch A, de Diego A
Servicio de Neumología. Hospital de Sagunto. Port de Sagunt. Valencia. España.
Arch Bronconeumol. 2005 May;41(5):267-71. doi: 10.1016/s1579-2129(06)60221-8.
Although the presence of hyperventilation syndrome can affect the symptoms of patients with asthma, there is very little information available regarding its frequency in Spain. The aim of this study was to investigate the prevalence of hyperventilation syndrome in the asthmatic population treated as outpatients and establish its relationship with anxiety disorders.
We studied 157 consecutive asthmatic patients (61 men and 96 women; mean [SD] age, 45 [17] years; forced expiratory volume in the first second, 84% [21%] of the predicted value) treated in our outpatients clinic. The patients had stable disease with varying degrees of severity. After collecting demographic data and medical histories, we asked the patients to complete the Spanish versions of the Anxiety Sensitivity Index, the Asthma Symptom Checklist, and the Nijmegen questionnaire; in the latter test, a score of 23 or over was considered diagnostic for hyperventilation syndrome. Finally, patients were evaluated to determine whether they had suffered from panic disorder in the last 6 months (according to the criteria of the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders).
Hyperventilation syndrome was present in 57 asthmatic patients (36%) and panic disorder in 4 patients (2%). The majority of patients with hyperventilation syndrome were women (78% vs 51%; P=.001) and were older (49 vs 42; P=.01); they displayed more basal dyspnea (1.26 vs 0.89 on the Medical Research Council scale; P=.01), greater sensitivity to anxiety (P=.001), and went to the emergency room more often for exacerbations (P=.002). Patients with hyperventilation syndrome scored significantly higher on all subscales of the Asthma Symptoms Checklist. Finally, the variables introduced in the regression analysis (stepwise) to explain the score on the Nijmegen questionnaire (r(2)=0.57) were basal dyspnea and sensitivity to anxiety.
Approximately one third of the asthmatic patients treated in a pulmonology clinic also present hyperventilation syndrome. This cannot be explained by comorbidity of asthma with panic disorder, and is only partly linked to the symptoms associated with hyperventilation that appear during an asthma attack.
尽管过度通气综合征的存在会影响哮喘患者的症状，但在西班牙，关于其发病率的信息却非常少。本研究的目的是调查门诊治疗的哮喘患者中过度通气综合征的患病率，并确定其与焦虑症的关系。
我们研究了在我们门诊治疗的157例连续哮喘患者（61名男性和96名女性；平均[标准差]年龄，45[17]岁；第一秒用力呼气量，为预测值的84%[21%]）。这些患者病情稳定，严重程度各不相同。在收集人口统计学数据和病史后，我们要求患者完成西班牙文版的焦虑敏感性指数、哮喘症状清单和奈梅亨问卷；在后者的测试中，得分23分或以上被认为可诊断为过度通气综合征。最后，对患者进行评估，以确定他们在过去6个月内是否患有惊恐障碍（根据《精神障碍诊断与统计手册》第四版的标准）。
57例哮喘患者（36%）存在过度通气综合征，4例患者（2%）患有惊恐障碍。大多数过度通气综合征患者为女性（78%对51%；P = 0.001）且年龄较大（49对42；P = 0.01）；他们表现出更多的基础呼吸困难（医学研究委员会量表上为1.26对0.89；P = 0.01）、对焦虑更敏感（P = 0.001），并且因病情加重更频繁地前往急诊室（P = 0.002）。过度通气综合征患者在哮喘症状清单的所有子量表上得分显著更高。最后，回归分析（逐步）中用于解释奈梅亨问卷得分（r(2)=0.57）的变量是基础呼吸困难和对焦虑的敏感性。
在肺病诊所接受治疗的哮喘患者中，约三分之一也存在过度通气综合征。这不能用哮喘与惊恐障碍的共病来解释，并且仅部分与哮喘发作期间出现的与过度通气相关的症状有关。
