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哮喘患者在支气管收缩和运动期间导致呼吸困难的因素。

Factors contributing to dyspnoea during bronchoconstriction and exercise in asthmatic subjects.

作者信息

Killian K J, Summers E, Watson R M, O'Byrne P M, Jones N L, Campbell E J

机构信息

Dept of Medicine, McMaster University Medical Centre, Hamilton, Ontario, Canada.

出版信息

Eur Respir J. 1993 Jul;6(7):1004-10.

PMID:8370426
Abstract

The purpose of the present study was to identify: 1) whether dyspnoea during bronchoconstriction and exercise is related, in asthmatic subjects; and 2) to what extent baseline pulmonary function and respiratory muscle strength contribute to dyspnoea under both conditions. One hundred and seventy five consecutive subjects, referred with suspected asthma, rated the intensity of dyspnoea (Borg scale 0-10): 1) during the administration of doubling concentrations of methacholine to 32 mg.ml-1 methacholine, or until the baseline forced expiratory volume in one second (FEV1) was reduced by 20%; and 2) during incremental cycle ergometry (100 kpm.min-1 each minute) to maximal capacity. 138/175 subjects achieved a 20% reduction in their baseline FEV1; 18 of the 138 were excluded, 2 children and 16 with complicating pulmonary disorders (diffusing capacity of the lung for carbon monoxide (DLCO) and/or total lung capacity (TLC) < 70% predicted). The remaining 120 out of 175 constituted the study population. Dyspnoea following a 20% reduction in the baseline FEV1 (Dys20%) was linearly interpolated, using the rating of dyspnoea and the FEV1 at the two final concentrations of methacholine. In the 120 asthmatic subjects, the mean intensity of dyspnoea was "moderate" (2.9, SD 1.91; Borg 0-10) and the intensity across subjects was not significantly related to baseline FEV1, vital capacity (VC), FEV1/VC, DLCO, TLC and maximal static inspiratory pressure (MIP), alone or in combination.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

本研究的目的是确定

1)在哮喘患者中,支气管收缩和运动期间的呼吸困难是否相关;2)在这两种情况下,基线肺功能和呼吸肌力量在多大程度上导致呼吸困难。175名连续的疑似哮喘患者对呼吸困难强度进行评分(Borg量表0 - 10):1)在给予浓度加倍的乙酰甲胆碱直至32mg/ml乙酰甲胆碱,或直至基线一秒用力呼气量(FEV1)降低20%期间;2)在递增式自行车测力计运动(每分钟增加100kpm)至最大容量期间。138/175名受试者的基线FEV1降低了20%;这138名受试者中有18名被排除,2名儿童和16名患有复杂肺部疾病(肺一氧化碳弥散量(DLCO)和/或肺总量(TLC)<预测值的70%)。175名受试者中的其余120名构成了研究人群。使用在乙酰甲胆碱的两个最终浓度下的呼吸困难评分和FEV1,对基线FEV1降低20%后的呼吸困难(Dys20%)进行线性插值。在120名哮喘患者中,呼吸困难的平均强度为“中度”(2.9,标准差1.91;Borg 0 - 10),且受试者之间的强度与基线FEV1、肺活量(VC)、FEV1/VC、DLCO、TLC和最大静态吸气压力(MIP)单独或联合均无显著相关性。(摘要截断于250字)

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