深吸气对咳嗽变异性哮喘的支气管保护作用：气道疾病谱中的一个显著特征？
Bronchoprotective effect of deep inspirations in cough variant asthma: A distinguishing feature in the spectrum of airway disease?
作者信息
Wasilewski Nastasia V, Fisher Thomas, Turcotte Scott E, Fisher John T, Lougheed M Diane
机构信息
Department of Medicine, Kingston General Hospital and Queen's University, Kingston, ON, Canada; Department of Biomedical and Molecular Sciences, Queen's University, Kingston, ON, Canada.
Department of Medicine, Kingston General Hospital and Queen's University, Kingston, ON, Canada.
出版信息
Respir Physiol Neurobiol. 2018 Nov;257:55-64. doi: 10.1016/j.resp.2017.09.004. Epub 2017 Sep 14.
PURPOSE
To assess the effect of deep inspirations (DIs) on airway behaviour in individuals with classic asthma (CA), cough variant asthma (CVA), and methacholine (MCh)-induced cough but normal airway sensitivity (COUGH) during bronchoprovocation.
METHODS
Twenty-five adults (18 female; 44.8 ± 12.3 years (Mean ± SD); n = 9 CA, n = 9 CVA, and n = 7 COUGH) completed two single-dose MCh challenges, with and without DIs. Bronchoprotection was assessed by comparing changes in bronchoconstriction (FEV, FVC, FEV/FVC, FEF, FEF), gas trapping (RV, RV/TLC) and impulse oscillometry (IOS) measurements.
RESULTS
The% changes in FEV with and without DIs were not significantly different within any group. Decreases in FEF and FEF were greater in CA (p = 0.041 and p = 0.029), decreases in FVC (% predicted) and FEV/FVC(%) were less in CVA (p = 0.048 and p = 0.010), and increases in RV (L) and RV/TLC (% predicted) were less in COUGH (p = 0.007 and p = 0.028), respectively. No differences in IOS measurements were noted.
CONCLUSIONS
DIs triggered bronchoconstriction in CA, bronchoprotection in CVA, and prevented gas trapping in COUGH.
目的
评估深吸气（DI）对经典哮喘（CA）、咳嗽变异性哮喘（CVA）以及在支气管激发试验中对乙酰甲胆碱（MCh）诱发咳嗽但气道敏感性正常（COUGH）个体的气道行为的影响。
方法
25名成年人（18名女性；平均年龄44.8±12.3岁（均值±标准差）；9名CA患者、9名CVA患者和7名COUGH患者）完成了两次单剂量MCh激发试验，一次有DI，一次无DI。通过比较支气管收缩（FEV、FVC、FEV/FVC、FEF、FEF）、气体潴留（RV、RV/TLC）和脉冲振荡法（IOS）测量值的变化来评估支气管保护作用。
结果
在任何组内，有DI和无DI时FEV的变化百分比均无显著差异。CA组中FEF和FEF的下降幅度更大（p = 0.041和p = 0.029），CVA组中FVC（预测值百分比）和FEV/FVC（%）的下降幅度较小（p = 0.048和p = 0.010），COUGH组中RV（升）和RV/TLC（预测值百分比）的增加幅度较小（p = 0.007和p = 0.028）。IOS测量值无差异。
结论
深吸气在CA中引发支气管收缩，在CVA中起到支气管保护作用，并在COUGH中防止气体潴留。
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