van Aalderen W M, Postma D S, Koëter G H, Knol K
Department of Paediatrics, University Hospital, Groningen, The Netherlands.
Thorax. 1991 May;46(5):366-71. doi: 10.1136/thx.46.5.366.
A study was carried out to investigate whether an imbalance in the autonomic nervous system or release of histamine, or both, is responsible for the nocturnal increase in airflow obstruction in asthmatic children. The study comprised 18 children with allergic asthma, nine with (group 1) and nine without (group 2) nocturnal airflow obstruction, and an age matched control group. All drugs were withheld for three days before and during the study. On day 4 each child was admitted to hospital and a series of measurements was made every four hours for 24 hours. These included measurements of the forced expiratory volume in one second (FEV1), heart rate and sinus arrhythmia gap from an electrocardiogram (an indirect measure of parasympathetic activity) and urine sampling for determination of catecholamine and N'-methylhistamine concentrations (measures of sympathetic activity and histamine release respectively). Urinary N'-methylhistamine excretion was significantly higher over the 24 hours in children in group 1 than in children in group 2, and overnight values were also significantly higher in children in group 1 than those in group 2. Mean (SEM) values (mumol/mol creatinine) were 154.6 (11.2) in group 1 and 110 (11.2) in group 2 for 2400-0400 hours samples and 139.2 (13.1) and 101.2 (10.6) 0400-0800 hours samples. There was no evidence of decreased sympathetic or increased parasympathetic activity in association with the nocturnal airflow obstruction; noradrenaline concentrations were increased in group 1. These observations indicate that nocturnal airflow obstruction is associated with increased release of histamine overnight.
开展了一项研究，以调查自主神经系统失衡或组胺释放，或两者兼而有之，是否是导致哮喘儿童夜间气流阻塞增加的原因。该研究包括18名过敏性哮喘儿童，其中9名有夜间气流阻塞（第1组），9名无夜间气流阻塞（第2组），以及一个年龄匹配的对照组。在研究前和研究期间，所有药物均停用三天。第4天，每个孩子入院，并在24小时内每4小时进行一系列测量。这些测量包括一秒用力呼气量（FEV1）、心率和心电图的窦性心律失常间隙（副交感神经活动的间接测量），以及尿液采样以测定儿茶酚胺和N'-甲基组胺浓度（分别为交感神经活动和组胺释放的测量指标）。第1组儿童24小时内尿N'-甲基组胺排泄量显著高于第2组儿童，第1组儿童的夜间值也显著高于第2组儿童。24:00 - 04:00小时样本的平均（SEM）值（μmol/mol肌酐）在第1组为154.6（11.2），在第2组为110（11.2）；04:00 - 08:00小时样本的平均（SEM）值在第1组为139.2（13.1），在第2组为101.2（10.6）。没有证据表明夜间气流阻塞与交感神经活动降低或副交感神经活动增加有关；第1组去甲肾上腺素浓度升高。这些观察结果表明，夜间气流阻塞与夜间组胺释放增加有关。
