Institute of Respiratory Disease, Department of Medical and Occupational Sciences, University of Foggia, Ospedale Colonnello D'Avanzo, Via degli Aviatori 1, 71100 Foggia, Italy.
Respir Med. 2011 Feb;105(2):195-203. doi: 10.1016/j.rmed.2010.09.013. Epub 2010 Oct 20.
Dyspnea perception in asthmatics differs between subjects. Poor perception is usually associated with increased risk of asthma attack/exacerbation. The advanced stage of the disease and the presence of eosinophilic airways inflammation have been recently recognized as being responsible for poor dyspnea perception. However, few studies are available on this topic.
The aim of this study was to analyse the influence of inflammatory pattern, age and affective status on dyspnea perception in asthmatic subjects.
Seventy-one consecutive asthmatic patients were recruited and underwent induced sputum, exhaled NO measurement and breath condensate collection. Perception of dyspnea was evaluated as a BORG-VAS/FEV(1) slope before and after the broncho-reversibility test and correlated with the stage of asthma, inflammatory markers, age and depression scale.
Dyspnea perception decreases with the worsening of asthma, with the advance of age and of depression status. Furthermore, airways inflammation plays a key role in the decline of dyspnea perception as proved by the negative correlation observed between inflammatory cells in sputum, exhaled pH and NO and BORG-VAS/FEV(1) slope.
The results of our study suggested that airways inflammation, depression status, advance age and severity of asthma influence dyspnea perception and suggest a straight control to identify and better manage poor preceptor asthmatics.
哮喘患者的呼吸困难感知存在个体差异。通常情况下，较差的呼吸困难感知与哮喘发作/加重的风险增加相关。最近有研究认为，疾病的晚期阶段和气道嗜酸性粒细胞炎症的存在是导致较差呼吸困难感知的原因。然而，关于这一主题的研究较少。
本研究旨在分析炎症模式、年龄和情感状态对哮喘患者呼吸困难感知的影响。
招募了 71 例连续的哮喘患者，进行诱导痰、呼出气一氧化氮测量和呼吸冷凝液收集。在支气管可逆性试验前后，通过 BORG-VAS/FEV(1)斜率评估呼吸困难感知，并与哮喘分期、炎症标志物、年龄和抑郁量表相关联。
哮喘恶化、年龄增长和抑郁状态加重都会导致呼吸困难感知下降。此外，气道炎症在呼吸困难感知下降中起着关键作用，这一点可以从痰中炎症细胞、呼气 pH 值和 NO 值与 BORG-VAS/FEV(1)斜率之间的负相关关系中得到证实。
本研究结果表明，气道炎症、抑郁状态、年龄增长和哮喘严重程度会影响呼吸困难感知，并提示需要直接控制来识别和更好地管理感知较差的哮喘患者。
