Campbell A H, Pierce R
Heidelberg Repatriation Hospital, Victoria, Australia.
Respir Med. 1994 Feb;88(2):125-9. doi: 10.1016/0954-6111(94)90024-8.
We have analysed the clinical manifestations of nine patients with brief upper airway dysfunction (BUAD) who attended the thoracic department of a major teaching hospital between 1987 and 1991. Episodes of BUAD developed within 1-4 months of presentation in three patients but were undiagnosed for 2.5-12.5 years in six. The mean age at onset was 51 years ranging from 37 to 66 years. The episodes occurred at irregular intervals. They lasted approximately 1-5 min, were frightening and consisted of an initial phase of obstructive apneoa lasting a few seconds to 2 min and a second phase of respiratory distress with inspiratory stridor lasting 1-4 min. Daytime episodes occurred in all and at night in five, waking three of the patients from sleep. In most instances, throat irritability triggered the episodes which were often preceded by cough. Potential causes of throat irritability included respiratory tract infection, allergy, oesophageal reflux and obstructive sleep apnoea. After treatment of throat irritability BUAD has ceased for at least a year in six of the eight with adequate follow-up. In conclusion, BUAD has characteristics clinical features which should enable it to be recognized more frequently, ensuring successful management.
我们分析了1987年至1991年间在一家大型教学医院胸科就诊的9例短暂性上气道功能障碍（BUAD）患者的临床表现。3例患者在就诊后1 - 4个月内出现BUAD发作，但6例患者在2.5 - 12.5年内未被诊断出来。发病时的平均年龄为51岁，范围在37至66岁之间。发作间隔不规律。发作持续约1 - 5分钟，令人恐惧，包括一个持续几秒至2分钟的阻塞性呼吸暂停初始阶段和一个持续1 - 4分钟的伴有吸气性喘鸣的呼吸窘迫第二阶段。所有患者白天均有发作，5例夜间发作，其中3例患者被发作惊醒。在大多数情况下，咽喉刺激引发发作，发作前常伴有咳嗽。咽喉刺激的潜在原因包括呼吸道感染、过敏、食管反流和阻塞性睡眠呼吸暂停。在对咽喉刺激进行治疗后，8例中有6例在充分随访的情况下，BUAD已停止发作至少一年。总之，BUAD具有特征性的临床特征，应能使其更频繁地被识别，从而确保成功治疗。
