Objective:To observe the intervention effects of different concentrations of dexamethasone on the general situation and pulmonary histology of chronic asthma rats,and to explore the suitable intragastric dose of dexam...Objective:To observe the intervention effects of different concentrations of dexamethasone on the general situation and pulmonary histology of chronic asthma rats,and to explore the suitable intragastric dose of dexamethasone in the rat model of chronic asthma.Methods:75 healthy male Sprague-Dawley(SD)rats were randomly divided into normal group,M group,dexamethasone low dose,middle dose and high dose group by random number table.The rat model of chronic asthma was established by sensitization and challenge of ovalbumin(OVA).From the 20th day of the experiment,dexamethasone groups were given intragastric administration of 0.0625mg/(kg·d),0.125mg/(kg·d)and 0.5mg/(kg·d),respectively.The general situation of rats was observed and recorded.The histological changes of rat lungs were observed by HE staining and Masson staining.Results:The degree of inflammatory infiltration of bronchus and surrounding tissue in the M group was significantly higher than that in the normal group(P<0.01).The thickness of airway wall and smooth muscle and the deposition of airway collagen in the M group were significantly higher than those in the normal group(P<0.01).After one week of intervention,the average daily food intake and body mass of rats in the high dose group were significantly lower than those in the M group(P<0.01),and the increase in body mass in the middle and low dose groups was significantly slower than that in the M group(P<0.01).After 2 weeks of intervention,the average daily food intake of rats in the middle and low dose groups was significantly lower than that in the M group(P<0.01).After 4 weeks of intervention,the average daily food intake in the middle and low dose groups was significantly lower than that in the low dose group(P<0.01).The inflammatory infiltration of lung tissue in the middle and low dose groups was significantly less than that in the model group,and the thickness of airway wall and smooth muscle and the deposition of airway collagen in the middle and low dose groups were significantly lower than those in the model group(P<0.01).There was no difference between the two groups(P>0.05).A large number of rats in the high dose group died after 5 times of intervention.Three rats died in the DEXM group at the 5th week of intervention,and there was no death in the other group.Conclusion:Both middle and low doses of dexamethasone can be used as the positive control dose in the experiment of chronic asthmatic rats,but the late side effects of low dose of dexamethasone are less,so the low dose of dexamethasone may be a safer and more suitable dose for the experiment of chronic asthmatic rats.展开更多
Background: Poverty is an important surrogate marker for obstructive airway diseases (OAD). Slum constitutes a habitat wherein various poverty related parameters are perpetually prevalent in the ambience. 1/6th of wor...Background: Poverty is an important surrogate marker for obstructive airway diseases (OAD). Slum constitutes a habitat wherein various poverty related parameters are perpetually prevalent in the ambience. 1/6th of world population lives in slums yet there is no information regarding their health status in context to asthma and COPD. Aims: We investigated the prevalence of asthma and chronic-bronchitis symptoms and associated risk-factors in slum habitats of Pune city. Methodology: 7062 adult slum-dwellers living in 12 slums of Pune city were cross-sectionally interviewed by local healthcare workers with respiratory health questionnaire which was designed using respiratory symptoms of validated European Community Respiratory Health Survey (ECRHS II) questionnaire and International Union against Tuberculosis and Lung Disease (IUATLD) bronchial symptoms questionnaire. Results: The overall prevalence of selfreported asthma symptoms was 10% (18 - 40 years: 6.5%;>40 years: 13.5%). The overall prevalence of chronic bronchitis was 8.5% [18 - 40 years: 7% (males: 7%, females: 7%);>40 years: 10% (males: 10%, females: 10%)]. Increasing age (p = 0.00), female gender (p = 0.001), unemployment (0.00) current smoking (p = 0.00) and ex-smoking (p = 0.004) emerged as significant risk factor for asthma. While, ex-smoking (p = 0.004) and low-education status (p = 0.00) emerged as significant risk factors for chronic bronchitis. Conclusion: In slums reporting of asthma and chronic-bronchitis symptoms was much higher than what has been reported earlier from India. Asthma was commonly seen in females, old age, unemployed and ever-smokers. While chronic bronchitis was commonly seen in ex-smokers and illiterate subjects. Chronic bronchitis was equally distributed amongst male and females, despite 0% prevalence of smoking in females.展开更多
Although asthma and chronic obstructive pulmonary disease(COPD) are distinct airway diseases characterized by chronic inflammation, in some cases distinguishing between them is puzzling. For example, chronic smoking l...Although asthma and chronic obstructive pulmonary disease(COPD) are distinct airway diseases characterized by chronic inflammation, in some cases distinguishing between them is puzzling. For example, chronic smoking leads asthmatic inflammation to a differentiated pattern resembling the COPD inflammation, and in some cases to fixed obstruction as in COPD, and on the other hand, few COPD patients may present with airway reversibility. ACOS is the condition sharing features encountered both in asthma and COPD. Asthma-COPD overlap syndrome(ACOS) represents a diagnostic challenge in the clinical practice, since there is lack of specific indicators to distinguish it from asthma or COPD, and moreover, genetic risk factors, underlying pathology and molecular pathways, clinical characteristics, therapeutic interventions, response to treatment and prognosis are poorly described. The management of ACOS is recommended to be individualized and should target on the maximum effectiveness with the least side effects. Combination therapy with ICS/LABA or LAMA, or newly developed specific anti-eosinophil therapies and treatments specifically targeting neutrophils might be of relevance in the management of ACOS, but studies are needed in order to assess the response and prognosis. Based on the current knowledge about ACOS thus far, it would be recommended that we approached chronic obstructive airway disease rather by describing than by classifying the disease; this would allow us to have a picture that better describes the disease and to implement an individualized therapeutic approach, according to the custom phenotype. Nevertheless, more studies are needed in order to clarify several important issues with regard to ACOS, such as the genetic risk factors for developing ACOS, the links between genotype and phenotype, the molecular pathways and underlying mechanisms of ACOS, the identification of possible specific biomarkers for diagnosis and targeted treatment, the optimal therapeutic interventions, and finally, the prognosis of ACOS.展开更多
Moxibustion in dog days" is a unique therapy for chronic bronchitis and bronchial asthma by means of drug-seperated moxibustion. In the present paper, therapeutic methods, and clinical short-and long-term therape...Moxibustion in dog days" is a unique therapy for chronic bronchitis and bronchial asthma by means of drug-seperated moxibustion. In the present paper, therapeutic methods, and clinical short-and long-term therapeutic effects of "moxibustion in dog days" are introduced and it is indicated that "moxibustion in dog days" has very good the short-and long-term therapeutic effects, with the long-term therapeutic effect better than the short-term one, for chronic bronchitis and bronchial asthma. Also, the concrete methods for increase of the short-term therapeutic effect are put forward.展开更多
Asthma is the most common noncommunicable disease among children. It leads to substantial problems both in health and economic terms to individuals and families. This paper introduces a technological solution, Easy Br...Asthma is the most common noncommunicable disease among children. It leads to substantial problems both in health and economic terms to individuals and families. This paper introduces a technological solution, Easy Breathing, that supports the man-agement of childhood asthma, providing tools for both doctors and patients. Through the establishment of an asthma chronic care model, it combines doctors’ professional guidance and a gamification system to improve the compliance of patients with their treatments and to provide them with tools for the self-management of their disease. The system is in the testing phase, the first mockup has been developed and validated with 270 medical experts and patients, and it will be tested with 540 end-users over the next months.展开更多
Objective Asthma and chronic obstructive pulmonary disease(COPD)feature different inflammatory and cellular profiles in the airways,indicating that the cellular metabolic pathways regulating these disorders are distin...Objective Asthma and chronic obstructive pulmonary disease(COPD)feature different inflammatory and cellular profiles in the airways,indicating that the cellular metabolic pathways regulating these disorders are distinct.Methods We aimed to compare the serum metabolomic profiles among mild persistent asthmatic patients,individuals with stable COPD,and healthy subjects and to explore the potential metabolic biomarkers and pathways.The serum metabolomic profiles of 17 subjects with mild persistent asthma,17 subjects with stable COPD,and 15 healthy subjects were determined by an untargeted metabolomic an alysis utilizi ng liquid chromatography-mass spectrometry.A series of multivariate statistical an a lyses was subsequently used.Results Multivariate analysis indicated a distinct separation between the asthmatic patients and healthy controls in electrospray positive and negative ions modes,respectively.A total of 19 differential metabolites were identified.Similarly,a distinct separation between asthma and COPD subjects was detected in the two ions modes.A total of 16 differential metabolites were identified.Among the identified metabolites,the serum levels of hypoxanthine were markedly higher in asthmatic subjects compared with those in COPD or healthy subjects.Conclusions Patients with asthma present a unique serum metabolome,which can distinguish them from individuals with COPD and healthy subjects.Purine metabolism alteration may be distinct and involved in the pathogenesis of asthma.展开更多
Signifcant links between allergic rhinitis and asthma have been reported, and the united airway disease hypothesis is supported by numerous findings in epidemiologic, physiologic, pathologic, and immunologic studies. ...Signifcant links between allergic rhinitis and asthma have been reported, and the united airway disease hypothesis is supported by numerous findings in epidemiologic, physiologic, pathologic, and immunologic studies. The impact of allergic rhinitis on asthma has been esta-blished. On the other hand, the relationship between chronic rhinosinusitis and lung diseases has been under investigation. Chronic rhinosinusitis is a common disease, and the high prevalence of chronic rhinosinusitis in some kinds of lung diseases has been reported. Recent studies suggest that the treatment of chronic rhinosinusitis has beneficial effects in the management of asthma. Here, we present an overview of the current research on the relationship between chronic rhinosinusitis and lower airway diseases including asthma, chronic obstructive pul-monary disease, cystic fibrosis, diffuse panbronchiolitis, primary ciliary dyskinesia, idiopathic bronchiectasis, and allergic bronchopulmonary aspergillosis.展开更多
Objective Air pollution is a leading public health issue.This study investigated the effect of air quality and pollutants on pulmonary function and inflammation in patients with asthma in Shanghai.Methods The study mo...Objective Air pollution is a leading public health issue.This study investigated the effect of air quality and pollutants on pulmonary function and inflammation in patients with asthma in Shanghai.Methods The study monitored 27 asthma outpatients for a year,collecting data on weather,patient self-management[daily asthma diary,peak expiratory flow(PEF)monitoring,medication usage],spirometry and serum markers.To explore the potential mechanisms of any effects,asthmatic mice induced by ovalbumin(OVA)were exposed to PM_(2.5).Results Statistical and correlational analyses revealed that air pollutants have both acute and chronic effects on asthma.Acute exposure showed a correlation between PEF and levels of ozone(O_(3))and nitrogen dioxide(NO_(2)).Chronic exposure indicated that interleukin-5(IL-5)and interleukin-13(IL-13)levels correlated with PM_(2.5)and PM_(10)concentrations.In asthmatic mouse models,exposure to PM_(2.5)increased cytokine levels and worsened lung function.Additionally,PM_(2.5)exposure inhibited cell proliferation by blocking the NF-κB and ERK phosphorylation pathways.Conclusion Ambient air pollutants exacerbate asthma by worsening lung function and enhancing Th2-mediated inflammation.Specifically,PM_(2.5)significantly contributes to these adverse effects.Further research is needed to elucidate the mechanisms by which PM_(2.5)impacts asthma.展开更多
The pulmonary diffusing capacity for carbon monoxide(D_LCO)was measuredin 50 normal subjects,50 patients with emphysema and 31 with asthma.The results sh-owed that the D_LCO value of the asthma group was markedly high...The pulmonary diffusing capacity for carbon monoxide(D_LCO)was measuredin 50 normal subjects,50 patients with emphysema and 31 with asthma.The results sh-owed that the D_LCO value of the asthma group was markedly higher than that of thehealthy group,while the D_LCO/pr% and KCO values of the asthma group were similarto those of the healthy group.The values of D_LCO,D_LCO/pr% and KCO in the emphy-sema group were very significantly lower than those in the asthma and healthy groups.Our study suggests that the measurement of D_LCO is onc of the useful pulmonary func-tion tests in differentiation of emphysema from asthma.The mechanism ofdiffcrcnt D_LCOvalues between emphysema and asthma is discussed.The D_LCO values in patients withmild to severe emphysema gradually decreased with the severity of emphysema.The KCOvalues between the mild emphysema and healthy groups were dramatically different.Thisis helpful in the early diagnosis of emphysma as combined with other clinical data.展开更多
<b>Background:</span></b><span style="font-family:""><span style="font-family:Verdana;"> Tidal expiratory flow limitation (tEFL) is defined as absence of increase...<b>Background:</span></b><span style="font-family:""><span style="font-family:Verdana;"> Tidal expiratory flow limitation (tEFL) is defined as absence of increase in air flow during forced expiration compared to tidal breathing and is related to dyspnea at rest and minimal exertion in patients with chronic airflow limitation (CAL). Tidal EFL has not been expressed as a continuous variable (0% - 100%) in previous analyses. </span><b><span style="font-family:Verdana;">Objective:</span></b><span style="font-family:Verdana;"> To relate the magnitude of tEFL to spirometric values and Modified Medical Research Council (MMRC) score and Asthma Control Test (ACT). </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> Tidal EFL was computed as percent of the tidal volume (0% - 100%) spanned (intersected) by the forced expiratory-volume curve. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">Of 353 patients screened, 192 (114 M, 78 F) patients (136 with COPD, 56 with asthma) had CAL. Overall characteristics: (mean ± SD) age 59 ± 11 years, BMI 28 ± 7, FVC (% pred) 85 ± 20, FEV1 (% pred) 66 ± 21, FEV1/FVC 55% ± 10%, RV (% pred) 147 ± 42. Tidal EFL in patients with tEFL was 53% ± 39%. Using univariate analysis, strongest correlations were between tEFL and FVC and between tEFL and RV in patients with BMI < 30 kg/m</span><sup><span style="font-family:Verdana;">2</span></sup><span style="font-family:Verdana;">. In patients with nonreversible CAL, tEFL was positively associated with increasing MMRC, negatively with spirometric measurements, and positively with RV/TLC. In asthmatics, ACT scores were higher in patients with mean BMI ≥ 28 kg/m</span><sup><span style="font-family:Verdana;">2</span></sup><span style="font-family:Verdana;"> (p < 0.00014) and RV/TLC values > 40% (p < 0.03). </span><b><span style="font-family:Verdana;">Conclusions:</span></b><span style="font-family:Verdana;"> Dyspnea is strongly associated with tEFL and lung function, particularly in patients with nonreversible CAL. Air trapping and </span><span style="font-family:Verdana;">BMI contribute to tEFL.展开更多
基金National Natural Science Foundation of China(81373600)
文摘Objective:To observe the intervention effects of different concentrations of dexamethasone on the general situation and pulmonary histology of chronic asthma rats,and to explore the suitable intragastric dose of dexamethasone in the rat model of chronic asthma.Methods:75 healthy male Sprague-Dawley(SD)rats were randomly divided into normal group,M group,dexamethasone low dose,middle dose and high dose group by random number table.The rat model of chronic asthma was established by sensitization and challenge of ovalbumin(OVA).From the 20th day of the experiment,dexamethasone groups were given intragastric administration of 0.0625mg/(kg·d),0.125mg/(kg·d)and 0.5mg/(kg·d),respectively.The general situation of rats was observed and recorded.The histological changes of rat lungs were observed by HE staining and Masson staining.Results:The degree of inflammatory infiltration of bronchus and surrounding tissue in the M group was significantly higher than that in the normal group(P<0.01).The thickness of airway wall and smooth muscle and the deposition of airway collagen in the M group were significantly higher than those in the normal group(P<0.01).After one week of intervention,the average daily food intake and body mass of rats in the high dose group were significantly lower than those in the M group(P<0.01),and the increase in body mass in the middle and low dose groups was significantly slower than that in the M group(P<0.01).After 2 weeks of intervention,the average daily food intake of rats in the middle and low dose groups was significantly lower than that in the M group(P<0.01).After 4 weeks of intervention,the average daily food intake in the middle and low dose groups was significantly lower than that in the low dose group(P<0.01).The inflammatory infiltration of lung tissue in the middle and low dose groups was significantly less than that in the model group,and the thickness of airway wall and smooth muscle and the deposition of airway collagen in the middle and low dose groups were significantly lower than those in the model group(P<0.01).There was no difference between the two groups(P>0.05).A large number of rats in the high dose group died after 5 times of intervention.Three rats died in the DEXM group at the 5th week of intervention,and there was no death in the other group.Conclusion:Both middle and low doses of dexamethasone can be used as the positive control dose in the experiment of chronic asthmatic rats,but the late side effects of low dose of dexamethasone are less,so the low dose of dexamethasone may be a safer and more suitable dose for the experiment of chronic asthmatic rats.
文摘Background: Poverty is an important surrogate marker for obstructive airway diseases (OAD). Slum constitutes a habitat wherein various poverty related parameters are perpetually prevalent in the ambience. 1/6th of world population lives in slums yet there is no information regarding their health status in context to asthma and COPD. Aims: We investigated the prevalence of asthma and chronic-bronchitis symptoms and associated risk-factors in slum habitats of Pune city. Methodology: 7062 adult slum-dwellers living in 12 slums of Pune city were cross-sectionally interviewed by local healthcare workers with respiratory health questionnaire which was designed using respiratory symptoms of validated European Community Respiratory Health Survey (ECRHS II) questionnaire and International Union against Tuberculosis and Lung Disease (IUATLD) bronchial symptoms questionnaire. Results: The overall prevalence of selfreported asthma symptoms was 10% (18 - 40 years: 6.5%;>40 years: 13.5%). The overall prevalence of chronic bronchitis was 8.5% [18 - 40 years: 7% (males: 7%, females: 7%);>40 years: 10% (males: 10%, females: 10%)]. Increasing age (p = 0.00), female gender (p = 0.001), unemployment (0.00) current smoking (p = 0.00) and ex-smoking (p = 0.004) emerged as significant risk factor for asthma. While, ex-smoking (p = 0.004) and low-education status (p = 0.00) emerged as significant risk factors for chronic bronchitis. Conclusion: In slums reporting of asthma and chronic-bronchitis symptoms was much higher than what has been reported earlier from India. Asthma was commonly seen in females, old age, unemployed and ever-smokers. While chronic bronchitis was commonly seen in ex-smokers and illiterate subjects. Chronic bronchitis was equally distributed amongst male and females, despite 0% prevalence of smoking in females.
文摘Although asthma and chronic obstructive pulmonary disease(COPD) are distinct airway diseases characterized by chronic inflammation, in some cases distinguishing between them is puzzling. For example, chronic smoking leads asthmatic inflammation to a differentiated pattern resembling the COPD inflammation, and in some cases to fixed obstruction as in COPD, and on the other hand, few COPD patients may present with airway reversibility. ACOS is the condition sharing features encountered both in asthma and COPD. Asthma-COPD overlap syndrome(ACOS) represents a diagnostic challenge in the clinical practice, since there is lack of specific indicators to distinguish it from asthma or COPD, and moreover, genetic risk factors, underlying pathology and molecular pathways, clinical characteristics, therapeutic interventions, response to treatment and prognosis are poorly described. The management of ACOS is recommended to be individualized and should target on the maximum effectiveness with the least side effects. Combination therapy with ICS/LABA or LAMA, or newly developed specific anti-eosinophil therapies and treatments specifically targeting neutrophils might be of relevance in the management of ACOS, but studies are needed in order to assess the response and prognosis. Based on the current knowledge about ACOS thus far, it would be recommended that we approached chronic obstructive airway disease rather by describing than by classifying the disease; this would allow us to have a picture that better describes the disease and to implement an individualized therapeutic approach, according to the custom phenotype. Nevertheless, more studies are needed in order to clarify several important issues with regard to ACOS, such as the genetic risk factors for developing ACOS, the links between genotype and phenotype, the molecular pathways and underlying mechanisms of ACOS, the identification of possible specific biomarkers for diagnosis and targeted treatment, the optimal therapeutic interventions, and finally, the prognosis of ACOS.
文摘Moxibustion in dog days" is a unique therapy for chronic bronchitis and bronchial asthma by means of drug-seperated moxibustion. In the present paper, therapeutic methods, and clinical short-and long-term therapeutic effects of "moxibustion in dog days" are introduced and it is indicated that "moxibustion in dog days" has very good the short-and long-term therapeutic effects, with the long-term therapeutic effect better than the short-term one, for chronic bronchitis and bronchial asthma. Also, the concrete methods for increase of the short-term therapeutic effect are put forward.
文摘Asthma is the most common noncommunicable disease among children. It leads to substantial problems both in health and economic terms to individuals and families. This paper introduces a technological solution, Easy Breathing, that supports the man-agement of childhood asthma, providing tools for both doctors and patients. Through the establishment of an asthma chronic care model, it combines doctors’ professional guidance and a gamification system to improve the compliance of patients with their treatments and to provide them with tools for the self-management of their disease. The system is in the testing phase, the first mockup has been developed and validated with 270 medical experts and patients, and it will be tested with 540 end-users over the next months.
基金funded by the National Natural Science Foundation of China-Youth Fund Project [No.81400017,81700039,81800038]the National Natural Science Foundation of China Emergency Management Project [No.81641153]
文摘Objective Asthma and chronic obstructive pulmonary disease(COPD)feature different inflammatory and cellular profiles in the airways,indicating that the cellular metabolic pathways regulating these disorders are distinct.Methods We aimed to compare the serum metabolomic profiles among mild persistent asthmatic patients,individuals with stable COPD,and healthy subjects and to explore the potential metabolic biomarkers and pathways.The serum metabolomic profiles of 17 subjects with mild persistent asthma,17 subjects with stable COPD,and 15 healthy subjects were determined by an untargeted metabolomic an alysis utilizi ng liquid chromatography-mass spectrometry.A series of multivariate statistical an a lyses was subsequently used.Results Multivariate analysis indicated a distinct separation between the asthmatic patients and healthy controls in electrospray positive and negative ions modes,respectively.A total of 19 differential metabolites were identified.Similarly,a distinct separation between asthma and COPD subjects was detected in the two ions modes.A total of 16 differential metabolites were identified.Among the identified metabolites,the serum levels of hypoxanthine were markedly higher in asthmatic subjects compared with those in COPD or healthy subjects.Conclusions Patients with asthma present a unique serum metabolome,which can distinguish them from individuals with COPD and healthy subjects.Purine metabolism alteration may be distinct and involved in the pathogenesis of asthma.
基金Supported by JSPS KAKENHI(Grants-in-Aid for Scientific Research),No.25462642
文摘Signifcant links between allergic rhinitis and asthma have been reported, and the united airway disease hypothesis is supported by numerous findings in epidemiologic, physiologic, pathologic, and immunologic studies. The impact of allergic rhinitis on asthma has been esta-blished. On the other hand, the relationship between chronic rhinosinusitis and lung diseases has been under investigation. Chronic rhinosinusitis is a common disease, and the high prevalence of chronic rhinosinusitis in some kinds of lung diseases has been reported. Recent studies suggest that the treatment of chronic rhinosinusitis has beneficial effects in the management of asthma. Here, we present an overview of the current research on the relationship between chronic rhinosinusitis and lower airway diseases including asthma, chronic obstructive pul-monary disease, cystic fibrosis, diffuse panbronchiolitis, primary ciliary dyskinesia, idiopathic bronchiectasis, and allergic bronchopulmonary aspergillosis.
基金supported by Shanghai Science and Technology Commission with Project(No.14411951100,No.21s31900400)。
文摘Objective Air pollution is a leading public health issue.This study investigated the effect of air quality and pollutants on pulmonary function and inflammation in patients with asthma in Shanghai.Methods The study monitored 27 asthma outpatients for a year,collecting data on weather,patient self-management[daily asthma diary,peak expiratory flow(PEF)monitoring,medication usage],spirometry and serum markers.To explore the potential mechanisms of any effects,asthmatic mice induced by ovalbumin(OVA)were exposed to PM_(2.5).Results Statistical and correlational analyses revealed that air pollutants have both acute and chronic effects on asthma.Acute exposure showed a correlation between PEF and levels of ozone(O_(3))and nitrogen dioxide(NO_(2)).Chronic exposure indicated that interleukin-5(IL-5)and interleukin-13(IL-13)levels correlated with PM_(2.5)and PM_(10)concentrations.In asthmatic mouse models,exposure to PM_(2.5)increased cytokine levels and worsened lung function.Additionally,PM_(2.5)exposure inhibited cell proliferation by blocking the NF-κB and ERK phosphorylation pathways.Conclusion Ambient air pollutants exacerbate asthma by worsening lung function and enhancing Th2-mediated inflammation.Specifically,PM_(2.5)significantly contributes to these adverse effects.Further research is needed to elucidate the mechanisms by which PM_(2.5)impacts asthma.
文摘The pulmonary diffusing capacity for carbon monoxide(D_LCO)was measuredin 50 normal subjects,50 patients with emphysema and 31 with asthma.The results sh-owed that the D_LCO value of the asthma group was markedly higher than that of thehealthy group,while the D_LCO/pr% and KCO values of the asthma group were similarto those of the healthy group.The values of D_LCO,D_LCO/pr% and KCO in the emphy-sema group were very significantly lower than those in the asthma and healthy groups.Our study suggests that the measurement of D_LCO is onc of the useful pulmonary func-tion tests in differentiation of emphysema from asthma.The mechanism ofdiffcrcnt D_LCOvalues between emphysema and asthma is discussed.The D_LCO values in patients withmild to severe emphysema gradually decreased with the severity of emphysema.The KCOvalues between the mild emphysema and healthy groups were dramatically different.Thisis helpful in the early diagnosis of emphysma as combined with other clinical data.
文摘<b>Background:</span></b><span style="font-family:""><span style="font-family:Verdana;"> Tidal expiratory flow limitation (tEFL) is defined as absence of increase in air flow during forced expiration compared to tidal breathing and is related to dyspnea at rest and minimal exertion in patients with chronic airflow limitation (CAL). Tidal EFL has not been expressed as a continuous variable (0% - 100%) in previous analyses. </span><b><span style="font-family:Verdana;">Objective:</span></b><span style="font-family:Verdana;"> To relate the magnitude of tEFL to spirometric values and Modified Medical Research Council (MMRC) score and Asthma Control Test (ACT). </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> Tidal EFL was computed as percent of the tidal volume (0% - 100%) spanned (intersected) by the forced expiratory-volume curve. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">Of 353 patients screened, 192 (114 M, 78 F) patients (136 with COPD, 56 with asthma) had CAL. Overall characteristics: (mean ± SD) age 59 ± 11 years, BMI 28 ± 7, FVC (% pred) 85 ± 20, FEV1 (% pred) 66 ± 21, FEV1/FVC 55% ± 10%, RV (% pred) 147 ± 42. Tidal EFL in patients with tEFL was 53% ± 39%. Using univariate analysis, strongest correlations were between tEFL and FVC and between tEFL and RV in patients with BMI < 30 kg/m</span><sup><span style="font-family:Verdana;">2</span></sup><span style="font-family:Verdana;">. In patients with nonreversible CAL, tEFL was positively associated with increasing MMRC, negatively with spirometric measurements, and positively with RV/TLC. In asthmatics, ACT scores were higher in patients with mean BMI ≥ 28 kg/m</span><sup><span style="font-family:Verdana;">2</span></sup><span style="font-family:Verdana;"> (p < 0.00014) and RV/TLC values > 40% (p < 0.03). </span><b><span style="font-family:Verdana;">Conclusions:</span></b><span style="font-family:Verdana;"> Dyspnea is strongly associated with tEFL and lung function, particularly in patients with nonreversible CAL. Air trapping and </span><span style="font-family:Verdana;">BMI contribute to tEFL.
