Kullowatz Antje, Rosenfield David, Dahme Bernhard, Magnussen Helgo, Kanniess Frank, Ritz Thomas
Department of Environmental Health, Harvard University, Boston, MA, USA.
Psychosom Med. 2008 May;70(4):468-75. doi: 10.1097/PSY.0b013e31816f9c2f.
To examine the association of changes in current negative mood and long-term daily hassles with changes in lung function and airway inflammation in patients suffering from asthma and in healthy controls. Associations between psychological factors and asthma symptoms have been documented, but the relationship between airway inflammation and psychological factors has been largely unexplored.
Data were analyzed from 46 asthma patients and 25 controls who completed questionnaires on current mood and daily hassles at two assessments 3 months apart. Lung function was measured by spirometry (forced expiratory volume in the first second (FEV(1))) and airway inflammation by the fraction of nitric oxide in exhaled air (FeNO). Regression analyses controlling for allergen load and air pollution (ozone) were calculated to study the association between changes in psychological factors and changes in lung function and airway inflammation, and to examine the mediational role of airway inflammation in the stress-lung function association.
In patients with asthma, increases in negative affect were associated with decreases in FEV(1) and increases in FeNO. For daily hassles, a reverse pattern of associations was found, with decreases in daily hassles linked to decreases in FEV(1) and increases in FeNO. Mediation analyses showed that FeNO was a significant mediator of the association of both negative affect and daily hassles with lung function changes. No significant associations were found for healthy controls.
Psychological variables are consistently associated with spirometric lung function and airway inflammation in asthma patients. For asthma patients, effects of acute negative affect must be distinguished from more chronic distress due to daily hassles.
研究哮喘患者和健康对照中当前负面情绪及长期日常困扰的变化与肺功能和气道炎症变化之间的关联。心理因素与哮喘症状之间的关联已有文献记载，但气道炎症与心理因素之间的关系在很大程度上尚未得到探索。
分析了46例哮喘患者和25例对照的数据，这些患者和对照在相隔3个月的两次评估中完成了关于当前情绪和日常困扰的问卷。通过肺量计测量肺功能（第一秒用力呼气量（FEV(1)）），通过呼出气体中一氧化氮分数（FeNO）测量气道炎症。计算控制过敏原负荷和空气污染（臭氧）的回归分析，以研究心理因素变化与肺功能和气道炎症变化之间的关联，并检验气道炎症在应激-肺功能关联中的中介作用。
在哮喘患者中，负面影响的增加与FEV(1)的降低和FeNO的增加相关。对于日常困扰，发现了相反的关联模式，即日常困扰的减少与FEV(1)的降低和FeNO的增加相关。中介分析表明，FeNO是负面影响和日常困扰与肺功能变化关联的重要中介。在健康对照中未发现显著关联。
心理变量与哮喘患者的肺量计肺功能和气道炎症始终相关。对于哮喘患者，必须区分急性负面影响的影响与日常困扰引起的更慢性的痛苦。
