3分钟呼吸运动试验对呼吸困难的感知可预测哮喘加重：前瞻性队列研究
2009/10/15
3分钟呼吸运动试验（3MRET）可对呼吸困难感知进行评估，本项前瞻性试验研究了3MRET在鉴别哮喘加重患者中的作用。研究共纳入146例稳定期哮喘患者（42 例感知不足, 69例感知正常,35例感知过度），进行为期12个月的随访。感知不足、感知正常和感知过度组中计划外就诊的平均（SD）次数分别为1.8 (1.2)、2.2 (1.8)和3.1 (2.3)（p = 0.008）；平均（SD）住院次数分别为1.3 (0.5), 1.2 (0.6)和1.7 (1.3)（p = 0.026）。与感知正常者相比，感知过度者计划外就诊危险和住院危险（≥2次/12个月）均显著增加，优势比(OD)分别为：5.12(95%CI 1.59～16.47) 和0.31(95% CI 0.23～0.41)。在校正了第1秒末用力呼气量（FEV(1)）后，感知过度与计划外就诊仍具有显著相关性。感知过度对计划外就诊的敏感性和特异性分别为77%和47%；对住院次数的敏感性和特异性分别为37%和78%；且计划外就诊的ROC曲线下面积（0.67 [95% CI 0.56～0.77]; p = 0.003）显著优于住院次数（0.58 [0.471～ 0.70]; p = 0.127）。结论：3MRET在对伴有呼吸困难感知过度的哮喘加重危险患者的鉴别中可能具有重要作用。
（苏楠 审校）
Loh LC, et al. J Asthma. 2009 Aug;46(6):529-534.
Perception of breathlessness by a 3-minute respiratory exerciser test predicts asthma exacerbations: a prospective cohort study.
Loh LC, Teh PN.
We prospectively evaluated the use of a simple 3-Minute Respiratory Exerciser Test (3MRET) that estimates perception of dyspnea to identify patients at risk of asthma exacerbations. A total of 146 stable asthmatics (42 under-perceivers, 69 normal perceivers, and 35 over-perceivers) received follow-up for 12 months. The mean (SD) unscheduled visits to doctors among under-, normal, and over-perceivers were 1.8 (1.2), 2.2 (1.8), and 3.1 (2.3), respectively (p = 0.008). The mean (SD) hospital admissions among the groups were 1.3 (0.5), 1.2 (0.6), and 1.7 (1.3), respectively (p = 0.026). Compared to normal perceivers, over-perceivers had increased risks of unscheduled visits (OD: 5.12; 95% CI = 1.59 to 16.47) and hospital admissions (OD: 0.31; 95% CI = 0.23 to 0.41), defined as > or =2 events in 12 months. The association between over-perceiver and unscheduled visits remained significant after adjusting for forced expiratory volume in 1 second (FEV(1)). Sensitivity and specificity of over-perceivers are 77% and 47%, respectively, for unscheduled visits and 37% and 78%, respectively, for hospital admissions, with significantly better area under ROC for unscheduled visits (0.67 [95% CI = 0.56 to 0.77]; p = 0.003) than for hospital admissions (0.58 [0.471 to 0.70]; p = 0.127). We conclude that the 3MRET may have a role in identifying asthmatic patients with over-perception of dyspnea at risk of clinically important asthma exacerbations.
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吸入甘露醇在哮喘诊断上的特征：一项人口学研究
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脉冲振荡法检测哮喘患儿对甘露醇的气道反应性
