Yanai M, Ohrui T, Sekizawa K, Sasaki H, Takishima T
First Department of Internal Medicine, Tohoku University School of Medicine, Sendai, Japan.
Thorax. 1989 Sep;44(9):743-8. doi: 10.1136/thx.44.9.743.
The panting manoeuvre may be used during the assessment of airway resistance and in asthmatic patients during bronchial provocation testing or spontaneous asthma. To study whether panting opens the larynx in patients with asthma, laryngeal resistance was examined in six patients with stable asthma before and after methacholine induced bronchoconstriction and in another six patients with spontaneous asthma. Subjects were asked to pant and then to hold their breath immediately afterwards. Laryngeal resistance after panting was compared to that during quiet tidal breathing. Change in laryngeal resistance was estimated by a method using low frequency sound and respiratory resistance by forced oscillation at 10 Hz. Mean baseline respiratory resistance during inspiration was 0.245 and 0.470 kPa/l.s before and after methacholine in the patients with stable asthma and 0.480 kPa/l.s in the patients with spontaneous asthma. In the patients with stable asthma mean laryngeal resistance was lower after panting than during the preceding quiet tidal breathing, both before and after methacholine induced bronchoconstriction (by 0.08 before and by 0.065 kPa/l.s after). In contrast, the patients with spontaneous asthma showed an increase in laryngeal resistance after panting of 0.089 kPa/l.s. The magnitude of change in laryngeal resistance after panting was similar to the change in respiratory resistance in the patients with spontaneous asthma and in the patients with stable asthma after methacholine, but was greater than the change in respiratory resistance in the patients with stable asthma before methacholine. These results suggest that panting may cause different effects on the laryngeal aperture in patients with stable and spontaneous asthma.
喘息动作可用于评估气道阻力,也可在支气管激发试验或自发性哮喘发作期间用于哮喘患者。为了研究喘息是否能使哮喘患者的喉部张开,我们对6例稳定期哮喘患者在乙酰甲胆碱诱发支气管收缩前后以及另外6例自发性哮喘患者进行了喉部阻力检查。受试者被要求进行喘息,然后立即屏气。将喘息后的喉部阻力与安静潮式呼吸时的喉部阻力进行比较。喉部阻力的变化通过一种使用低频声音的方法进行估计,呼吸阻力通过10Hz的强迫振荡来测量。稳定期哮喘患者在乙酰甲胆碱给药前和给药后吸气时的平均基线呼吸阻力分别为0.245和0.470kPa/l·s,自发性哮喘患者为0.480kPa/l·s。在稳定期哮喘患者中,无论是在乙酰甲胆碱诱发支气管收缩之前还是之后,喘息后的平均喉部阻力均低于之前安静潮式呼吸时的阻力(之前降低了0.08,之后降低了0.065kPa/l·s)。相比之下,自发性哮喘患者喘息后喉部阻力增加了0.089kPa/l·s。喘息后喉部阻力的变化幅度与自发性哮喘患者以及乙酰甲胆碱给药后稳定期哮喘患者的呼吸阻力变化相似,但大于乙酰甲胆碱给药前稳定期哮喘患者的呼吸阻力变化。这些结果表明,喘息可能对稳定期和自发性哮喘患者的喉口产生不同的影响。