哮喘联盟

   摘要
   背景：众所周知，呼出气一氧化氮(FeNO)水平受多种内、外因素的影响。压力和抑郁情绪与FeNO水平变化有关，但是，长久持续的心理压力对哮喘患者FeNO有何影响，尚不可知。
   目的：本研究旨在评估学生在低压力期（学期中）和高压力期（期末考试期间的5天）FeNO、肺功能、内源性皮质醇水平的变化。
   方法：一项关于期末考试压力的研究，纳入处于学期中（低压力期）和期末考试期间（高压力期）的109名受试者（其中35名患有哮喘）纳入分析。分三个时间点测定FeNO、肺功能（第1秒用力呼气量即FEV1以及峰值流速）、唾液皮质醇及消极情绪。用药情况、感冒症状、性别和年龄均为控制变量。
   主要结果：从基线的低压力期到考试期间的高压力期，FeNO大幅下降，且患有哮喘的学生下降幅度显著高于对照组，分别为-11.5ppb 和-1.2ppb。两组FEVI均有下降。期末考试期间消极情绪加重、皮质醇水平增加，但是，两者在哮喘患者中的增加幅度较小。初始情绪越低落、压力越大及皮质醇水平增加越多，与期末考试期间FeNO降低幅度越大有关。应用吸入性激素并不能改变以上变化。
   结论：基线压力水平、抑郁情绪与哮喘患者FeNO和肺功能的下降伴随发生。因此，在监测哮喘患者FeNO变化的同时，也应注意其生活压力的变化及情绪的波动。

 

（杨冬 审校）
Ann Am Thorac Soc. 2015 Sep 8. [Epub ahead of print]


 

Exhaled Nitric Oxide Decreases during Academic Examination Stress in Asthma.
 

Ritz T1, Trueba AF2, Liu J3, Auchus RJ4, Rosenfield D5.
 

Abstract
RATIONALE:Fractional exhaled nitric oxide (FeNO) is known to vary with multiple endogenous and exogenous factors. Laboratory stress and depressive mood have been associated with altered FeNO levels but little is known about the susceptibility of FeNO to longer lasting states of psychological stress in asthma.
OBJECTIVE:We sought to study changes in FeNO, lung function, and endogenous cortisol levels in students in a low-stress period during the academic term and in high-stress periods of up to 5 days during final exams.
METHODS:109 participants (35 with asthma) enrolled in a final examination stress study were assessed during the academic term (low-stress) and during final exams (high-stress). FeNO, spirometric lung function (forced expiratory volume in the 1st s, FEV1, peak flow), salivary cortisol, and negative affect were measured at three time points. Control variables were medication use, cold symptoms, sex and age.
MEASUREMENTS AND MAIN RESULTS:FeNO decreased substantially from low-stress baseline to the high-stress examination periods, with more pronounced decreases occurring in asthma (- 11.5ppb) than controls (-1.2ppb). FEV1 decreased in both groups. Negative affect and cortisol increased during final exams, but these increases were smaller in asthma. Greater initial depression, perceived stress, and greater cortisol increases were related to larger FeNO decreases during the final exam period. Inhaled corticosteroid use did not affect these changes.
CONCLUSION:Baseline perceived stress and depressive mood are accompanied by decreases in both FeNO and lung function in asthma. Fluctuations related to life stress and mood levels should be considered in FeNO monitoring for asthma.
 

Ann Am Thorac Soc. 2015 Sep 8. [Epub ahead of print]