Veidal Sandra, Jeppegaard Maria, Sverrild Asger, Backer Vibeke, Porsbjerg Celeste
Respiratory Research Unit, Department of Respiratory Medicine, Bispebjerg University Hospital, Copenhagen, Denmark.
Respiratory Research Unit, Department of Respiratory Medicine, Bispebjerg University Hospital, Copenhagen, Denmark.
Respir Med. 2017 Feb;123:42-47. doi: 10.1016/j.rmed.2016.12.008. Epub 2016 Dec 18.
Dysfunctional breathing (DB) is a respiratory disorder, which involves a pattern of breathing too deeply, too superficially and/or too rapidly. In asthma patients, DB may lead to an overestimation of the severity of asthma symptoms, and hence potentially to overtreatment. However, it is not known to which degree DB may affect estimates of asthma control, in a specialist clinical setting.
The MAPOut-study examined all patients referred consecutively over a 12-months period for specialist assessment of asthma at the Respiratory Outpatient Clinic at Bispebjerg Hospital in Copenhagen. All patients were examined with the Nijmegen questionnaire with a DB defined as a score ≥23 and the ACQ questionnaire. Linear regression analysis of predictors of ACQ score was performed. Asthma was defined as asthma symptoms and a positive asthma test.
Of the 256 patients referred to the lung clinic, data on both the Nijmegen questionnaire and ACQ score was obtained in 127 patients, who were included in the present analysis. Median (range) age: 30 (15-63) years, and 76 (59.8%) were females. DB was found in 31 (24.4%). Asthmatic patients with co-existing DB had a poorer asthma control compared to asthmatics without DB (Median (range) ACQ score: 2.40 (0.20-4.60) vs 1.20 (0.00-4.40); p < 0.001.). A regression analysis showed that the effect of DB on asthma control was independent of airway hyperresponsiveness or airway inflammation in patients with DB.
Dysfunctional breathing is common among asthma patients in a specialist setting, and results in a clinically significant underestimation of asthma control, which may potentially lead to overtreatment.
功能性呼吸障碍（DB）是一种呼吸系统疾病，其呼吸模式表现为过深、过浅和/或过快。在哮喘患者中，DB可能导致对哮喘症状严重程度的高估，进而可能导致过度治疗。然而，在专科临床环境中，DB对哮喘控制评估的影响程度尚不清楚。
MAPOut研究对哥本哈根比斯佩耶尔医院呼吸门诊连续12个月转诊进行哮喘专科评估的所有患者进行了检查。所有患者均使用奈梅亨问卷进行检查，DB定义为得分≥23，并使用哮喘控制问卷（ACQ）进行检查。对ACQ得分的预测因素进行线性回归分析。哮喘定义为哮喘症状和哮喘试验阳性。
在转诊至肺病门诊的256例患者中，127例患者获得了奈梅亨问卷和ACQ得分的数据，并纳入本分析。中位（范围）年龄：30（15 - 63）岁，76例（59.8%）为女性。发现31例（24.4%）存在DB。与无DB的哮喘患者相比，合并DB的哮喘患者哮喘控制较差（中位（范围）ACQ得分：2.40（0.20 - 4.60） vs 1.20（0.00 - 4.40）；p < 0.001）。回归分析表明，DB对哮喘控制的影响独立于DB患者的气道高反应性或气道炎症。
在专科环境中，功能性呼吸障碍在哮喘患者中很常见，会导致临床上对哮喘控制的显著低估，这可能会导致过度治疗。
