Peripheral airway involvement in asthma assessed by single-breath SF6 and He washout

被引:38
作者
Gustafsson, PM [1 ]
Ljungberg, HK
Kjellman, B
机构
[1] Queen Silvia Childrens Hosp, Dept Paediat Clin Physiol, S-41685 Gothenburg, Sweden
[2] Cent Hosp Skovde, Dept Pediat, Skovde, Sweden
[3] Inst Child Hlth, Intens Therapy & Resp Med Unit, Portex Anaesthesia, London, England
关键词
acinar; airway hyperresponsiveness; bronchioli; challenge;
D O I
10.1183/09031936.03.00049302
中图分类号
R56 [呼吸系及胸部疾病];
学科分类号
摘要
The aim of the study was to assess how deep into the acinar region the airway response to cold dry-air hyperventilation challenge (CACh) reaches in subjects with asthma of different severity. Peripheral airway function was measured using a single-breath sulphur hexafluoride (SF6) and helium (He) washout test and overall airway function by forced expiratory volume in one second (FEV1) at rest, after CACh and beta(2)-therapy in 55 adults with a history of asthma. The normalised phase-III slopes (Sn-III) for SF6 and He were used to assess peripheral airway obstruction and the (SF6-He) Sun, difference to indicate where obstruction occurred. While a greater He versus SF6 slope increase indicates a response close to the acinar entrance, the reverse indicates a response deeper into the acinar airspaces. Twelve subjects had a major fall in FEV1 (greater than or equal to 20%) after CACh, 16 a minor fall (10-19%), and 27 did not react. Resting He and SF6 Sun, were significantly greater in major responders with respect to minor and nonresponders, while resting FEV1 did not differ between the three groups. The major responders showed marked increases of He and SF6 Sun, after CACh, with greater increase for He resulting in a negative (SF6-He) Sun, difference. To conclude, airways close to the acinar entrance participate in the overall airway response to cold-air challenge in asthmatic adults with marked airway hyper-responsiveness to cold, dry air.
引用
收藏
页码:1033 / 1039
页数:7
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