Van Keimpema A R, Ariaansz M, Tamminga J J, Nauta J J, Postmus P E
Department of Pulmonology, Free University Hospital, Amsterdam, The Netherlands.
Respiration. 1997;64(1):29-34. doi: 10.1159/000196639.
The occurrence of nocturnal waking due to asthma and morning dip of the peak expiratory flow (PEF), and the associated patient characteristics were investigated in 103 clinically stable asthmatic patients from a pulmonary outpatient clinic. Analysis of a 1 week diary showed a mean week morning PEF dip (i.e. morning/daytime highest PEF) of 12%. A mean dip of > or = 20% was found in 20% of the patients. Three groups were distinguished: 10% were 'nocturnal-waking patients' (waking up > or = 2 nights a week with a PEF dip of > or = 20%); 19% 'morning-dipping patients' (patients with > or = 3 dips a week of > or = 20% but with waking up on < 2 nights a week) leaving 71% 'remaining patients'. 28% of all patients showed morning PEF dips. In a questionnaire, waking every night was reported by 9%, at least once a week by 42% and once a month by 72%. In 'nocturnal-waking patients' FEV1 and morning and evening PEFs were lower than in 'remaining patients'; complaints during the night and on rising were more severe. The morning PEF dip was the same in 'nocturnal-waking patients' and 'morning-dipping patients'. The occurrence of waking was the same in 'morning-dipping patients' and in the 'remaining patients'. There were no differences in other clinical parameters among the three groups. We conclude that a subset of clinically stable asthma patients presents morning dips and nocturnal waking. They do not differ substantially from the remaining patients in other clinical characteristics.
对一家肺科门诊的103例临床稳定的哮喘患者，调查了哮喘导致的夜间觉醒、呼气峰值流速（PEF）的早晨下降情况以及相关的患者特征。对1周日记的分析显示，平均每周早晨PEF下降（即早晨/白天最高PEF）为12%。20%的患者平均下降≥20%。区分出三组：10%为“夜间觉醒患者”（每周觉醒≥2晚，PEF下降≥20%）；19%为“早晨下降患者”（每周有≥3次下降≥20%，但每周夜间觉醒<2晚），其余71%为“其余患者”。所有患者中有28%出现早晨PEF下降。在一份问卷中，9%的患者报告每晚觉醒，42%的患者报告至少每周一次，72%的患者报告每月一次。“夜间觉醒患者”的第一秒用力呼气容积（FEV1）以及早晨和晚上的PEF低于“其余患者”；夜间和起床时的症状更严重。“夜间觉醒患者”和“早晨下降患者”的早晨PEF下降情况相同。“早晨下降患者”和“其余患者”的觉醒发生率相同。三组患者的其他临床参数无差异。我们得出结论，一部分临床稳定的哮喘患者存在早晨下降和夜间觉醒。他们在其他临床特征方面与其余患者没有实质性差异。
