Iwasaki Y, Hashinoto S, Hashikura H, Mizobuchi K, Arimoto T, Ito H, Gotoh T, Hara H, Nakamura T, Nakagawa M
Second Department of Medicine, Kyoto Prefectural University of Medicine, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1995 May;33(5):483-8.
Asthmatic patients have a circadian rhythm in peak expiratory flow rate (PEFR). The present study was done to measure the effect of inhaled beclomethasone dipropionate (BDP) on the circadian rhythm of PEFR in asthmatic patients. After two weeks of observation, BDP (400 micrograms) was given by metered dose inhaler to nine asthmatic patients. The dose of inhaled BDP (800-1200 micrograms) was increased every two weeks until PEFR varied by no more than 20% each day. PEFR was measured four times daily: on waking, around noon, in the evening, and at bedtime. Nine asthmatic patients had a significant (p < 0.05) rhythm detectable by single cosinor analysis, both during the observation period and during treatment. Analysis by the group mean-cosinor method showed that the mean mesor was 397.3 +/- 6.8 l/min, the mean amplitude was 54.3 +/- 7.1 l/min, and the mean acrophase was at 16:31 +/- 0.27 before treatment. After treatment, the mean mesor was 543.8 +/- 4.4 l/min, the mean amplitude was 30.5 +/- 4.9 l/minm, and the mean acrophase was at 16:25 +/- 0.31. The mean mesor had increased significantly (p < 0.05), and the mean amplitude had decreased significantly (p < 0.05) after treatment. The mean acrophase did not change. These data indicate that inhaled BDP increases PEFR at a constant acrophase in asthmatic patients.
哮喘患者的呼气峰值流速（PEFR）存在昼夜节律。本研究旨在测量吸入丙酸倍氯米松（BDP）对哮喘患者PEFR昼夜节律的影响。经过两周的观察后，通过定量吸入器给9名哮喘患者使用BDP（400微克）。每两周增加吸入BDP的剂量（800 - 1200微克），直至PEFR每天的变化不超过20%。每天测量PEFR四次：醒来时、中午前后、晚上和就寝时。9名哮喘患者在观察期和治疗期间，通过单余弦分析均检测到显著（p < 0.05）的节律。通过组均值 - 余弦分析方法显示，治疗前平均中值为397.3 +/- 6.8升/分钟，平均振幅为54.3 +/- 7.1升/分钟，平均峰相位在16:31 +/- 0.27。治疗后，平均中值为543.8 +/- 4.4升/分钟，平均振幅为30.5 +/- 4.9升/分钟，平均峰相位在16:25 +/- 0.31。治疗后平均中值显著增加（p < 0.05），平均振幅显著降低（p < 0.05）。平均峰相位未改变。这些数据表明，吸入BDP可使哮喘患者在恒定的峰相位下增加PEFR。
