Department of Allergy and Clinical Immunology, Transylvania University, Faculty of Medicine, 56 Nicolae Balcescu, Brasov, Romania.
Clin Transl Allergy. 2012 Sep 19;2(1):18. doi: 10.1186/2045-7022-2-18.
Abnormal breathing patterns may cause characteristic symptoms and impair quality of life. In a cross-sectional survey 29% of adults treated for asthma in primary care had symptoms suggestive of dysfunctional breathing (DB), more likely to be female and younger, with no differences for severity of asthma. No clear risk factors were demonstrated for DB in asthma, nor the impact of asthma medication was evaluated. The objective of this study was to describe the DB phenotype in adults with asthma treated in a specialised asthma centre.
Adult patients aged 17-65 with diagnosed asthma were screened for DB using the Nijmegen questionnaire (positive predictive score >23) and confirmed by progressive exercise testing. The following were evaluated as independent risk factors for DB in the multiple regression analysis: female sex; atopy, obesity, active smoker, moderate/severe rhinitis, psychopathology, GERD, arterial hypertension; severe asthma, asthma duration > 5 years, lack of asthma control, fixed airway obstruction, fast lung function decline, frequent exacerbator and brittle asthma phenotypes; lack of ICS, use of LABA or LTRA.
91 adults with asthma, mean age 35.04 ±1.19 years, 47(51.65%) females were evaluated. 27 (29.67%) subjects had a positive screening score on Nijmegen questionnaire and 16(17.58%) were confirmed by progressive exercise testing as having DB. Independent risk factors for DB were psychopathology (p = 0.000002), frequent exacerbator asthma phenotype (p = 0.01) and uncontrolled asthma (p < 0.000001).
Dysfunctional breathing is not infrequent in asthma patients and should be evaluated in asthma patients presenting with psychopathology, frequent severe asthma exacerbations or uncontrolled asthma. Asthma medication (ICS, LABA or LTRA) had no significant relation with dysfunctional breathing.
异常的呼吸模式可能导致特征性症状并降低生活质量。在一项横断面调查中，29%在初级保健中接受哮喘治疗的成年人出现了提示呼吸功能障碍（DB）的症状，这些患者更可能为女性和年轻人，且哮喘严重程度无差异。在哮喘中，没有明确的 DB 危险因素，也没有评估哮喘药物的影响。本研究的目的是描述在专门的哮喘中心接受治疗的哮喘成年人的 DB 表型。
使用 Nijmegen 问卷（阳性预测评分>23）对年龄在 17-65 岁之间诊断为哮喘的成年患者进行 DB 筛查，并通过逐步运动试验进行确认。在多元回归分析中，将以下因素评估为 DB 的独立危险因素：女性；特应性、肥胖、现吸烟、中重度鼻炎、精神病理学、GERD、动脉高血压；严重哮喘、哮喘持续时间>5 年、哮喘控制不佳、固定气道阻塞、肺功能快速下降、频繁加重和脆性哮喘表型；缺乏 ICS、使用 LABA 或 LTRA。
共评估了 91 名哮喘患者，平均年龄为 35.04±1.19 岁，其中 47 名（51.65%）为女性。27 名（29.67%）患者 Nijmegen 问卷筛查呈阳性，16 名（17.58%）通过逐步运动试验证实为 DB。DB 的独立危险因素为精神病理学（p=0.000002）、频繁加重的哮喘表型（p=0.01）和未控制的哮喘（p<0.000001）。
在哮喘患者中，呼吸功能障碍并不少见，在出现精神病理学、频繁严重哮喘加重或未控制的哮喘的患者中应评估呼吸功能障碍。哮喘药物（ICS、LABA 或 LTRA）与呼吸功能障碍无显著关系。
