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主动和被动任务期间哮喘患者行为任务诱导的支气管扩张:心理诱导气道变化可能的胆碱能联系

Behavioral task-induced bronchodilation in asthma during active and passive tasks: a possible cholinergic link to psychologically induced airway changes.

作者信息

Lehrer P M, Hochron S, Carr R, Edelberg R, Hamer R, Jackson A, Porges S

机构信息

Robert Wood Johnson Medical School, University of Medicine and Dentistry of New Jersey, Department of Psychiatry, Piscataway 08854-5635, USA.

出版信息

Psychosom Med. 1996 Sep-Oct;58(5):413-22. doi: 10.1097/00006842-199609000-00004.

Abstract

This study investigated pulmonary and autonomic reactions to active and passive behavioral laboratory tasks among asthmatic subjects. It also examined the relationship between airway irritability, as measured by the methacholine challenge test (MCT), and autonomic activity and reactivity to these tasks. Fifty-one asthmatic and 37 nonasthmatic subjects were exposed to psychological laboratory tasks involving either active (mental arithmetic and reaction time) or passive (films depicting shop accidents and thoracic surgery) response. The MCT was given to asthmatics in a separate session. Active tasks reduced respiratory impedance, as measured by forced oscillation pneumography. They also increased heart rate and appeared to block vagal activity, as measured by respiratory sinus arrhythmia (RSA). Airway irritability as assessed by the MCT was positively related to amplitude of RSA and to skin conductance levels. Our data suggest that active and passive behavioral tasks may produce different pulmonary effects among both asthmatic and nonasthmatic individuals. Engaging in tasks requiring active responses may produce temporary improvements in pulmonary function. No autonomic differences were obtained between asthmatics and nonasthmatics in physiological response to stress, but greater cholinergic receptor sensitivity was suggested among high responders to methacholine.

摘要

本研究调查了哮喘患者对主动和被动行为实验室任务的肺部及自主神经反应。研究还检验了通过乙酰甲胆碱激发试验(MCT)测定的气道易激性与自主神经活动及对这些任务的反应性之间的关系。51名哮喘患者和37名非哮喘患者接受了涉及主动(心算和反应时间)或被动(描绘商店事故和胸外科手术的影片)反应的心理实验室任务。哮喘患者在另一次单独测试中接受MCT。主动任务降低了通过强迫振荡肺功能描记法测量的呼吸阻抗。这些任务还增加了心率,并且似乎阻断了通过呼吸性窦性心律不齐(RSA)测量的迷走神经活动。通过MCT评估的气道易激性与RSA幅度和皮肤电导水平呈正相关。我们的数据表明,主动和被动行为任务可能在哮喘患者和非哮喘患者中产生不同的肺部效应。从事需要主动反应的任务可能会使肺功能产生暂时改善。在对压力的生理反应方面,哮喘患者和非哮喘患者之间未获得自主神经差异,但对乙酰甲胆碱高反应者中提示有更高的胆碱能受体敏感性。

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