Aboussafy David, Campbell Tavis S, Lavoie Kim, Aboud Frances E, Ditto Blaine
Respiratory Division, Faculty of Medicine, University of British Columbia, Vancouver, Canada.
Int J Psychophysiol. 2005 Sep;57(3):195-201. doi: 10.1016/j.ijpsycho.2005.02.004.
The impact of stress on respiratory airflow in asthmatics is unclear. Part of the uncertainty may spring from the different physiological effects of different stressors. Given their potential to elicit increases in parasympathetic vagal activity, stressful situations that present few opportunities for coping (passive coping stressors) may be particularly problematic for people with asthma. Thirty-one adult asthmatics participated in a protocol including a widely used passive coping stressor (the cold pressor test), an active coping stressor (mental arithmetic), an interview about an upsetting asthma-related incident (viewed as a potential passive coping stressor given the exposure to unpleasant memories), and progressive muscle relaxation. Repeated measurements of airflow (via peak expiratory flow), vagal tone (via heart rate variability), and other variables were obtained. The cold pressor test, asthma interview and progressive muscle relaxation produced significant decreases in airflow compared to the baseline period. The cold pressor test and progressive muscle relaxation produced significant, complementary increases in vagal tone. These results suggest that passive coping stressors and other stimuli (e.g., certain forms of relaxation) that elicit increased vagal tone may be associated with poorer asthma control, a view consistent with a significant negative correlation between the participant's mean vagal tone response to the tasks and score on a measure of asthma self-efficacy.
压力对哮喘患者呼吸气流的影响尚不清楚。部分不确定性可能源于不同应激源的不同生理效应。鉴于其可能引发副交感迷走神经活动增加，几乎没有应对机会的应激情况（被动应对应激源）可能对哮喘患者尤其成问题。31名成年哮喘患者参与了一项方案，该方案包括一种广泛使用的被动应对应激源（冷加压试验）、一种主动应对应激源（心算）、一次关于令人苦恼的哮喘相关事件的访谈（鉴于接触不愉快记忆，被视为潜在的被动应对应激源）以及渐进性肌肉放松。对气流（通过呼气峰值流速）、迷走神经张力（通过心率变异性）和其他变量进行了重复测量。与基线期相比，冷加压试验、哮喘访谈和渐进性肌肉放松导致气流显著下降。冷加压试验和渐进性肌肉放松使迷走神经张力显著且互补性增加。这些结果表明，引发迷走神经张力增加的被动应对应激源和其他刺激（例如，某些形式的放松）可能与哮喘控制较差有关，这一观点与参与者对任务的平均迷走神经张力反应与哮喘自我效能测量得分之间的显著负相关一致。
