哮喘患者日常生活中体力活动、肺功能及气短情况研究
2011/09/09
背景：体力活动对哮喘患者的影响已被广泛探索。体育锻炼能引发许多患者迟发型支气管痉挛，患者为避免类似情况会减少运动，结果可能采取静坐生活方式。然而，体育活动对哮喘和健康最直接的影响是支气管舒张。迄今，对哮喘患者日常生活中体力活动和肺功能的联系知之甚少。
方法：使用活动的电子版日志与肺量计（PEF和FEV1）研究20例哮喘患者和20例健康受试者。受试者在本试验开始前30分钟对气短、体力活动强度及社会活动的程度做分级，然后评估接下来3周的受试情况，每天需评估3次（早晨、中午和夜晚）。
结果：强度较大的体力活动同时与较好的肺功能相关；相反，它也与同时发生的气短症状存在明显正相关。前瞻性交叉滞后分析（cross-lag analyses）显示，1天中较早出现低水平的PEF和FEV1预示着当天较晚出现的低水平体力活动和社会活动，而气短与此并无关联。
结论：该发现显示，运动诱发的支气管痉挛所致的不利影响不能推广到哮喘患者日常活动中的体力活动。然而，当进行较多的体力活动时，哮喘患者仍感觉存在更多的气短症状。他们可通过较早期的肺功能状况来调节自身的活动强度，然而这并不能完全解释其与体力活动和肺功能的一致的正相关关系。
(王刚 四川大学华西医院中西医结合科呼吸组 610041 摘译)
(Chest; 2010;138: 138;913-918)
Physical Activity, Lung Function,and Shortness of Breath in the Daily Lifeof Individuals With Asthma
Chest 2010;138;913-918
Background: The effects of physical activity on asthma have been explored extensively. Exercise can trigger later bronchoconstriction in many patients, and deconditioning due to a sedentary lifestyle may be the consequence. However, the immediate effect of physical activity in asthma and health is bronchodilation. To date, little is known about the association between physical activity and lung function in the daily life of asthma patients.
Methods: We studied 20 individuals with asthma and 20 control subjects using an electronic diary of activities and spirometry (peak expiratory flow [PEF], FEV1 ). Participants rated their shortness of breath and their intensity of physical and social activity for the preceding 30 min. Assessments were made over the course of 3 weeks, tid (morning, afternoon, evening/night).
Results: Stronger physical activity was concurrently associated with significantly higher lung function. In contrast, it also showed a positive concurrent association with shortness of breath. In prospective cross-lag analyses, lower PEF and FEV 1 earlier in the day predicted lower physical and social activity levels later in the day, but shortness of breath did not.
Conclusion: The findings show that detrimental effects observed in exercise-induced bronchoconstriction cannot be generalized to physical activity in daily lives of individuals with asthma. Nevertheless, people with asthma still feel more shortness of breath when being more physically active. They adjust their activity levels throughout the day according to their earlier lung function, but this does not fully explain the concurrent positive association of physical activity and lung function.
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患儿及其父母关于医生开展哮喘宣教的报告
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客观的气道监测在感冒和流感季节改善哮喘控制：一项整群随机试验
