Robinson Paul D, King Gregory G, Sears Malcolm R, Hong Chuen Y, Hancox Robert J
Woolcock Institute of Medical Research, The University of Sydney, Sydney, New South Wales, Australia.
Department of Respiratory Medicine, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.
Respirology. 2017 Aug;22(6):1110-1117. doi: 10.1111/resp.13045. Epub 2017 Apr 11.
Peripheral airway involvement in asthma remains poorly understood. We investigated impulse oscillometry (IOS) measures of peripheral airway function in a population-based birth cohort.
Pre- and post-bronchodilator spirometry and IOS measures of respiratory resistance and reactance were measured in 915 participants at age 38 years.
Current asthma was associated with impairments in both spirometry and IOS parameters. These impairments were greater in men and in those with childhood persistent asthma. Spirometry and IOS values for those whose asthma was in remission were not different to non-asthmatic participants. There were significant changes in IOS in both asthmatic and non-asthmatic participants after bronchodilator, but between-group differences persisted. Higher BMIs were associated with impairments in IOS but not spirometry. Cumulative tobacco use was associated with spirometric airflow obstruction in both sexes, whereas cannabis use was associated with impairments in IOS in women. Despite higher lifetime exposure, there were few associations between cannabis and IOS in men.
Asthma is associated with abnormalities in IOS measures of peripheral airway dysfunction. This association is stronger in men and in those with asthma persisting since childhood. Tobacco and cannabis use are associated with different patterns of spirometry and IOS abnormalities and may affect the bronchial tree at different airway generations with differences in susceptibility between sexes.
哮喘患者外周气道受累情况仍未得到充分了解。我们在一个基于人群的出生队列中研究了外周气道功能的脉冲振荡法（IOS）测量指标。
对915名38岁参与者进行了支气管扩张剂使用前后的肺量计检查以及呼吸阻力和电抗的IOS测量。
目前的哮喘与肺量计和IOS参数受损有关。这些损害在男性和患有儿童持续性哮喘的患者中更为严重。哮喘缓解者的肺量计和IOS值与非哮喘参与者无差异。支气管扩张剂使用后，哮喘患者和非哮喘患者的IOS均有显著变化，但组间差异仍然存在。较高的体重指数与IOS受损有关，但与肺量计无关。累积吸烟与两性的肺量计气流阻塞有关，而大麻使用与女性的IOS受损有关。尽管男性终生接触大麻的机会更高，但大麻与男性IOS之间的关联很少。
哮喘与外周气道功能障碍的IOS测量异常有关。这种关联在男性和自幼患哮喘的患者中更强。烟草和大麻使用与不同模式的肺量计和IOS异常有关，可能在不同气道节段影响支气管树，且两性易感性存在差异。
