Gunen Hakan, Hacievliyagil Suleyman Savas, Kosar Feridun, Gulbas Gazi, Kizkin Ozkan, Sahin Ibrahim
Department of Pulmonary Medicine, Turgut Ozal Research Center, Inonu University, Malatya, Turkey.
Allergy Asthma Proc. 2006 Jan-Feb;27(1):45-52.
The severity of bronchial asthma may not be assessed easily in some patients using the current evaluation methods. In this study, we aimed to obtain more objective and detailed data in evaluating patients with stable mild and moderate bronchial asthma and to validate the current parameters against more objective ones in determining the disease severity. One-hundred six stable patients with bronchial asthma were included in the study. These patients underwent spirometric and cardiological examination, 6-minute walk testing (6MWT) and arterial blood gas analysis. Continuous measurement of pulse oxymetry (SpO2) was done during 6MWT. Dyspnea that developed during 6MWT was measured using the modified Borg category scale. Sixteen patients were found severely hypoxemic at rest, and 16 patients were severely desaturated at 6MWT. Nineteen patients had pulmonary hypertension on echocardiography. Patients with oxygenation problems were older and had longer disease duration, lower forced expiratory flow of 25-75%, higher Borg exercise rating, and higher pulmonary artery pressure (p < 0.05). Patients with pulmonary hypertension had earlier disease onset, lower forced expiratory flow of 25-75%, lower arterial oxygen tension and lower pre-6MWT SpO2 (p < 0.05), older age, and lower SpO2 at 6MWT (p < 0.01). Classic evaluation methods correctly operated only on the two-thirds of asthmatic patients. Cardiological examination, 6MWT, and arterial blood gas analysis were needed for the true evaluation of other patients who had potentially progressive disease. We think that evaluation of asthmatic patients with these more objective and detailed methods provides important additional clinical data.
对于一些患者而言，使用当前的评估方法可能难以轻易评估支气管哮喘的严重程度。在本研究中，我们旨在获取更客观、详细的数据以评估稳定期轻度和中度支气管哮喘患者，并在确定疾病严重程度时，将当前参数与更客观的参数进行验证。本研究纳入了106例稳定期支气管哮喘患者。这些患者接受了肺功能和心脏检查、6分钟步行试验（6MWT）以及动脉血气分析。在6MWT期间持续测量脉搏血氧饱和度（SpO2）。使用改良的博格分类量表测量6MWT期间出现的呼吸困难。发现16例患者静息时严重低氧，16例患者在6MWT时严重血氧饱和度下降。19例患者经超声心动图检查发现患有肺动脉高压。有氧合问题的患者年龄更大、病程更长、25%-75%用力呼气流量更低、博格运动评分更高、肺动脉压更高（p<0.05）。患有肺动脉高压的患者发病更早、25%-75%用力呼气流量更低、动脉血氧分压更低、6MWT前SpO2更低（p<0.05）、年龄更大、6MWT时SpO2更低（p<0.01）。经典评估方法仅能正确评估三分之二哮喘患者。对于其他可能患有进展性疾病的患者，真正的评估需要进行心脏检查、6MWT和动脉血气分析。我们认为，使用这些更客观、详细的方法评估哮喘患者可提供重要的额外临床数据。
