老年哮喘患者潮式呼吸时气流阻力感受阈值增加
2012/05/08
背景:我们前期研究显示,一些老年非哮喘个体,感受静息状态下气流阻力增加的能力下降。
目的:研究气流阻力感受能力在老年哮喘患者存在下降。
方法:入选60名年龄20~88岁的稳定期哮喘患者。逐渐负载外部气流阻力,用于测量静息状态下潮式呼吸时吸气负载检测阈值(LDT)。
结果:平均吸气LDT在20~64岁组为5.57±4.33 kPa.s/l(n=32),在65岁及以上组为15.6±10.1(n=28)(P<0.0001)。吸气LDT与年龄(r=0.5246, P<0.00008)显著相关,主要由于接近一半以上年龄65岁以上的个体存在较高的LDT。呼气LDT值和相关性与吸气LDT值相似。
结论:某些老年哮喘患者潮式呼吸时感受外部阻力负荷的阈值与非哮喘个体相似。该研究结果对于哮喘治疗有指导意义,因为一些老年患者可能感受气流阻塞发作的能力下降,从而延迟使用急救用药。
(林江涛 审校)
Age Ageing. 2012 Mar 16. [Epub ahead of print]
The airflow resistance sensing threshold during tidal breathing rises in old age in patients with asthma.
Allen SC, Khattab A.
Source
Medicine and Geriatrics, Royal Bournemouth Hospital, Castle Lane East, Bournemouth BH7 7DW, UK.
Abstract
BACKGROUND: in a previous study, we showed that the ability to detect a rise in airflow resistance at rest was reduced in some non-asthmatic subjects in old age.
OBJECTIVE: to determine whether airflow resistance detection is attenuated in elderly subjects with asthma.
METHODS: we studied 60 adult subjects with stable asthma (age range 20-88). Progressive external airflow resistance loading was used to measure the inspiratory load detection threshold (LDT) during tidal breathing at rest.
RESULTS: the mean inspiratory LDT was 5.57 (4.33 SD) kPa.s/l in the 20-64 age group (n = 32) and 15.6 (10.1 SD) kPa.s/l in those aged 65 and above (n = 28) (P < 0.0001). The inspiratory LDT was significantly correlated with age (r = 0.5246, P < 0.00008), mainly due to the effect of higher LDTs in about half of the subjects above the age of 65 years. Expiratory LDT values and correlations were very similar to inspiratory values.
CONCLUSIONS: the threshold for detecting external resistive loads during tidal breathing rises in old age in some, but not all, asthmatic patients as was observed in non-asthmatic subjects. The finding has implications for treatment guidelines because some elderly subjects are likely to have reduced awareness of worsening airflow obstruction, and consequently delay their use of rescue treatments.
Age Ageing. 2012 Mar 16. [Epub ahead of print]
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