呼吸自主驱动力受损：抑郁症与哮喘患者不明原因通气衰竭之间的潜在联系。
Impaired voluntary drive to breathe: a possible link between depression and unexplained ventilatory failure in asthmatic patients.
作者信息
Allen G M, Hickie I, Gandevia S C, McKenzie D K
机构信息
Prince of Wales Hospital, Prince of Wales Medical Research Institute, Sydney, Australia.
出版信息
Thorax. 1994 Sep;49(9):881-4. doi: 10.1136/thx.49.9.881.
BACKGROUND
Although psychological distress predicts mortality in asthma, an underlying physiological link has not been shown. This study examined relations between impaired voluntary drive to breathe and measures of mood states.
METHODS
The level of maximal voluntary activation of the diaphragm and elbow flexors was measured in a previous study using a sensitive modification of the twitch interpolation technique in 11 asthmatic and 10 control subjects. In this study psychological distress was assessed using the Profile of Mood States questionnaire and measures of distress were compared with the muscle voluntary activation results.
RESULTS
For the asthmatic subjects, depressed mood increased the risk of impaired maximal voluntary activation of the diaphragm by 3.5 times (95% CI 1.09 to 11.3). No such association was observed in control subjects.
CONCLUSIONS
These results suggest that depressed mood may predispose an asthmatic patient to impaired voluntary activation of the diaphragm. Such individuals would be at increased risk of rapidly developing ventilatory failure if faced with severe airway narrowing.
背景
尽管心理困扰可预测哮喘患者的死亡率，但尚未发现其潜在的生理联系。本研究探讨了呼吸自主驱动受损与情绪状态指标之间的关系。
方法
在之前的一项研究中，采用对抽搐插值技术的灵敏改进方法，测量了11名哮喘患者和10名对照受试者的膈肌和肘屈肌最大自主激活水平。在本研究中，使用情绪状态剖面图问卷评估心理困扰，并将困扰指标与肌肉自主激活结果进行比较。
结果
对于哮喘患者，情绪低落使膈肌最大自主激活受损的风险增加3.5倍（95%可信区间1.09至11.3）。在对照受试者中未观察到此类关联。
结论
这些结果表明，情绪低落可能使哮喘患者易于出现膈肌自主激活受损。如果面临严重气道狭窄，此类个体迅速发生呼吸衰竭的风险会增加。
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