儿童夜间睡眠间歇性喘息
2010/07/06
摘要
夜间哮喘是难治性哮喘的一种，可以影响患者的生活质量。本研究目的是对夜间喘息的客观检测结果与临床状态、症状回忆和肺功能改变进行比较。9名9～16岁的哮喘儿童入选本研究，分析其在入选研究前的每日哮喘记录和前1周的峰值测量；除2名患者外，其他患者哮喘控制较好。采用连接于气管的声音呼吸描计传感器，持续监测夜间呼吸音并且对喘息进行量化分析。分析系统(PulmoTrack)根据固定程序检测喘息并排除干扰。夜间喘息发生率（Tw/Ttot=喘息持续时间/记录持续时间）每分钟计算1次。记录时间长达8小时，除2名儿童外，其他患者的喘息总时间在11到87分钟之间。睡眠期间喘息出现的形式多变，阵发性喘息出现于安静呼吸之间。夜间哮喘的主观感觉、次日第1秒用力呼气量（FEV1）与喘息的客观检测之间无相关性。夜间喘息与总的每日症状评分和日间呼气峰值流量（PEF）变异显著相关性。7名哮喘得到有效控制的患者中，4名在夜间出现喘息次数较多，喘息为阵发性，与常规肺功能检测及夜间症状无关。
（林江涛 审校）
Boner AL, et al. J Asthma. 2010 Apr;47(3):290-294.
Children with nocturnal asthma wheeze intermittently during sleep.
Boner AL, Piacentini GL, Peroni DG, Irving CS, Goldstein D, Gavriely N, Godfrey S.
Department of Pediatrics, University of Verona, Verona, Italy.
Abstract
Nocturnal asthma indicates poor overall control of asthma and adversely affects the quality of life of the patient. The purpose of the present study was to compare the objective measurement of nocturnal wheeze with clinical state, recall of symptoms, and changes in lung function. Nine asthmatic children aged 9 to 16 years were followed with an asthma diary and diurnal measurement of peak flow for a week before the nocturnal study; all but two were apparently well controlled. Breath sounds were recorded and analyzed continuously overnight to quantify wheeze using a phonopneumography sensor attached over the trachea. The analytical system (PulmoTrack) utilized an algorithm to detect wheeze and reject interference. The wheeze rate (Tw/Ttot = duration of wheeze/duration of recording) was calculated minute by minute throughout the night. Recordings lasted over 8 hours and all but two children had wheeze lasting for a total time of between 11 and 87 minutes. The pattern of wheezing was very variable during sleep, with episodes of wheeze separated by periods of quiet breathing. There was no relationship between subjective perception of nocturnal asthma, forced expiratory volume in 1 s (FEV(1)) next morning, and the objective measurement of wheeze. Total overnight wheeze was significantly related to the total diary symptom score and to the (small) diurnal variability of peak expiratory flow (PEF). Four of the seven children with asthma who were apparently well controlled had considerable amounts of wheeze during the night that was episodic in nature and unrelated to conventional measures of lung function or nocturnal symptoms.
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学龄前儿童采用脉冲振动技术检测支气管高反应性
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针对患者报告结果检测信息系统(PROMIS)构建儿童哮喘影响量表
