Effect of oral contraceptives on respiratory function

The present study was carried out to assess the lung functions in oral contraceptive administered women. Lung function tests were carried out with Spirometer (Vitallograph Compact II). A significant increase in vital capacity (VC) was observed in these women as compared to normal control. There was also a significant decrease in forced expiratory volume in 1 sec./vital capacity (FEV1/VC%) and forced expiratory volume in 1 sec./forced vital capacity (FEV1/FVC%) among oral contraceptive administered women as compared to controls. Further, a significant increase in peak expiratory flow rate (PEF), reduction in forced expiratory flow rate (FEF75-85%) and FEF75% were observed among oral contraceptive administered women as compared to controls. The increase in VC and PEF might be due to the synthetic form of progesterone (progestins) present in oral contraceptive pills which causes hyperventilatory changes. Synthetic progesterone during luteal phase of menstrual cycle might increase the static and dynamic volumes of lung i.e. VC and PEF. But FEF75% showed a decrease which might be due to the lower neuromuscular coordination during breathing.     

The effect of tiotropium on the pulmonary diffusing capacity

To our knowledge, there is no data on the effect of tiotropium on pulmonary gas exchange in healthy subjects. The aim of this study was to assess the effects of tiotropium on pulmonary diffusing capacity. Twenty-one healthy volunteers were enrolled for a prospective, randomized, double-blind, placebo-controlled study. Spirometric measurements, including pulmonary-diffusing capacity, were obtained before and after inhalation of drug or placebo. There was a significant decrease in forced vital capacity (FVC) and, consequently, an increase in the forced expiratory volume in one second (FEV1) to FVC ratio after placebo inhalation (p < 0.05), but no changes were found for percent-predicted FVC, FEV1, percent-predicted FEV1, percent-predicted forced expiratory flow (FEF25%-75%), percent-predicted peak expiratory flow (PEF), diffusing capacity of the lung for carbon monoxide (DLCO), single-breath alveolar volume (VA) and DLCO/VA ratio when compared with the baseline. Tiotropium inhalation caused a significant increase in FVC, percent-predicted FEV1, FEV1/FVC and percent-predicted FEF25%-75%, although the decrease in DLCO was insignificant (12.4 +/- 0.9 to 11.4 +/- 0.9). In conclusion, tiotropium does not change the pulmonary-diffusing capacity in healthy volunteers.     

肺高分辨率CT马赛克样灌注与小气道功能指数的相关分析

目的探讨肺小气道病变时高分辨率CT（HRCT）所示马赛克样灌注与小气道功能指标的相关性。方法选择HRCT上显示马赛克样灌注病例80例,由3位放射诊断医师对马赛克样灌注与小气道功能指标的相关性进行分析。结果马赛克样灌注与FEF 25%呈负相关（r=-0.48,P〈0.05）,与FEV1、FEF50%无相关性（r值分别为-0.27和-0.19,P〉0.05）。而空气潴留的程度与FEF25%、FEV1呈负相关（r值分别为-0.62和-0.41,P〈0.05）,与FEF 50%无相关性（r=-0.29,P〉0.05）。结论马赛克样灌注作为小气道病变的主要征象,其与FEF 25%具有良好的相关性,而空气潴留作为小气道阻塞的直接后果,其程度与FEV1、FEF 25%具显著相关性,即使肺功能检查结果正常时,也可以辅助诊断临床可疑的小气道阻塞。     

Determination of %FVC (FEV/FVC%) at expiratory flow rate of 1 lit/sec and 0.5 lit/sec from forced expiratory spirogram

A method for determination of %FVC (FEV/FVC%) at forced expiratory flow rate (FEF) of 1 lit./sec. and 0.5 lit/sec from the forced expiratory spirogram is described. This parameter is simpler to determine and is a better expression of end expiratory flow rate than FEF 75%-85%.     

小气道功能指标在儿童哮喘病情严重程度评估及临床诊断中的应用

目的 探讨小气道功能指标在儿童哮喘病情严重程度评估及临床诊断中的应用价值。方法 选取2013年5月至2016年4月于郑州市第二人民医院56例哮喘急性发作期病儿作为哮喘组,并根据哮喘急性发作严重程度分为轻度(21例)、中度(20例)和重度(15例)三个亚组,同时选取同期、年龄相仿及性别相匹配的30例因其他原因引起喘息咳嗽的慢性炎症病儿和32例入院检查健康儿童分别作为非哮喘组和对照组,收集各组儿童一般资料,采用肺功能测定系统检测各组儿童用力肺活量(FVC)、最大呼气流量(PEF)、第1秒用力呼气容积(FEV1)和FEV1/FVC比值、呼出25%肺活量时呼气流速(FEF25%)、呼出50%肺活量时呼气流速(FEF50%)、呼出75%肺活量时呼气流速(FEF75%)、最大中期呼气流速(MMEF)等指标。结果 与对照组比较,非哮喘组和哮喘组病儿FVC、FEV1、PEF、FEF25%、FEF50%、FEF75%和MMEF等指标均显著降低(P<0.05),且哮喘组病儿上述指标显著低于非哮喘组[(1.42±0.36)L比(1.85±0.47)L、(1.25±0.32)L比(1.42±0.41)L、(2.68±0.64)L比(3.25±0.77)L/s、(2.54±0.65)L/s比(3.74±0.68)L/s、(1.58±0.36)L/s比(2.24±0.71)L/s、(0.61±0.37)L/s比(1.02±0.41)L/s、(1.42±0.49)L/s比(1.89±0.68)L/s)](均P<0.05),而三组病儿FEV1/FVC指标差异无统计学意义(P>0.05)。哮喘急性发作期不同程度病儿用力呼出25%肺活量的呼气流量占预计值百分比(FEF25pred%)、用力呼出50%肺活量的呼气流量占预计值百分比(FEF50pred%)、用力呼出75%肺活量的呼气流量占预计值百分比(FEF75pred%)、最大呼气中期流量占预计值的百分比(MMEFpred%)等指标比较差异有统计学意义(P<0.05),且随着病情程度增加,病儿FEF25pred%、FEF50pred%、FEF75pred%、MMEFpred%等指标呈现明显降低趋势(P<0.05),FEF25%和FEF75%指标在不同严重程度哮喘病儿中异常率比较,差异有统计学意义(P<0.05),FEF50%和MMEF指标比较差异无统计学意义(P>0.05),其中FEF25%主要表现为轻度异常,而FEF75%主要表现为重度异常。结论 小气道功能指标在儿童哮喘病情严重程度评估及临床诊断具有重要意义,随着病情加剧,小气道功能指标明显降低,且异常率显著增加。     

沙美特罗/丙酸氟替卡松对哮喘儿童肺功能的改善及临床意义

目的:观察沙美特罗/丙酸氟替卡松对哮喘儿童肺功能改善情况。方法:采用德国Jaeger公司的MasterscreenIOS测定仪,对61例支气管哮喘患儿在沙美特罗/丙酸氟替卡松治疗前后进行通气肺功能(F-V)和脉冲振荡(IOS)检测。观察用力肺活量(FVC)、第一秒用力呼气容积(FEV1)、最大呼气流速(PEF)、呼出25%肺活量时最大呼气流量(FEF25)、呼出50%肺活量时最大呼气流量(FEF50)、呼出75%肺活量时最大呼气流量(FEF75);呼吸阻抗(Zrs)、气道总阻力(R5)、中心气道阻力(R20)、响应频率(Fres)。结果:沙美特罗/丙酸氟替卡松治疗后FVC、FEV1、PEF均明显升高(P<0.001),而Zrs、R5、R20、Fres均明显降低(P<0.05),两者检查结果均有显著统计学意义。结论:吸入沙美特罗/丙酸氟替卡松能改善哮喘儿童的肺通气功能,降低气道阻力,是治疗儿童哮喘的理想药物之一。     

Longitudinal study of lung function development in a cohort of Indian medical students: interaction of respiratory allergy and smoking

This study was done to identify some factors that affect the growth and development of lung function during adolescence and early adulthood. Forced expiratory spirograms and peak expiratory flow rates were obtained in a cohort of normal young men (n = 63) over a period of 4 years, at intervals of approximately 2 years. Two factors that disturbed the normal pattern of lung function development in this group were smoking and respiratory allergy. Among the smokers and the allergics the decline in the forced expiratory volume expressed as a percentage of the forced vital capacity (FEV1%), the forced expiratory flow in the middle half of the forced vital capacity (FEF25-75%) and the FEF25-75% expressed as a ratio of the forced vital capacity (FEF/FVC) was more than double that among the normal subjects. The number of smokers and of allergics increased during the course of the study from 15 to 19 and from 16 to 23 respectively. There was a significant (P less than .01) interaction between smoking and the manifestation of respiratory allergy. Among nonsmokers, the number of allergic subjects increased from 12 to 13, while among smokers it increased from 4 to 10, during the four years.     

Comparison of fenoterol, isoproterenol, and isoetharine with phenylephrine aerosol in asthma

The bronchodilator effect of fenoterol hydrobromide (0.5, 1.25, and 2.5 mg) was compared with either isoproterenol (2.8 mg) or isoetharine (5 mg) with phenylephrine (1.25 mg) in a double-blind placebo-controlled study. When delivered by an intermittent positive-pressure breathing device to 24 nonsmoking young adult asthmatic subjects, fenoterol produced significant improvement in forced expiratory volume at 1 second (FEV1), in maximum midexpiratory flow (FEF25-75%), and in forced expiratory flow at 25 per cent of vital capacity (FEF25%) for 6 to 8 hours, whereas isoproterenol and isoetharine with phenylephrine produced improvement for 1 and 2 hours, respectively. The lowest dosage of fenoterol was as effective as the highest but had fewer adverse effects.     

Prediction equation for lung functions in South Indian children

Lung functions including VC, IVC, FVC, FEV0.5, FEV1, PEF, FEF0.2-1.2, FEF25-75%, FEF75-85%, PIF, FMFT, MVV(IND), peak expiratory flow at 25%, 50% and 75% of FVC, peak inspiratory flow at 75%, 50%, 25% and the ratio between different lung volumes were measured with Vitallograph Compact-II spirometer on 109 South Indian school boys in the age group of five to sixteen years. The results show an increase in "lung volumes" and "flow rates" with increase in age, height and weight. FMFT and MVV(IND) also increase with increase in anthropometric measurements. All the lung functions except FEF75-85% and the ratio between different lung volumes show significant positive correlation with age, height and weight. Regression equations were derived for predicting normal lung functions for healthy South Indian boys. Lung volumes and flow rates were lower than North Indian and foreign boys. The decrease in lung functions in South Indian boys were due to their sea level dwelling, dietary habits and comparatively lower anthropometric measurements.     

Bronchial lability in allergic rhinitis.

The aim of this study was to assess the relationship between exercise bronchial lability and the changes in pulmonary function over a one year period in allergic rhinitis. Eighty four nonsmoking male medical students of whom twenty two were allergic rhinitics were studied. Pulmonary function status was significantly lower and exercise bronchial lability significantly higher in the allergics. Over a one year period the mean decline in the forced expiratory volume in one second (FEV1) was three times greater and in the forced expiratory flow rate in the middle half of the vital capacity (FEF 25-75%) 50% greater among the allergics. The change in FEV1 was positively related to the bronchial lability, indicating that greater bronchial lability was associated with less decline in pulmonary function in these subjects.     

Inhaled dopamine induces bronchodilatation in patients with bronchial asthma.

OBJECTIVE: To determine the probable bronchodilating effect of dopamine administered by inhalation route in patients with crisis of bronchial asthma and the effect of dopamine on bronchial motor tone. DESIGN AND METHOD: We have studied eighteen (18) patients with crisis of bronchial asthma, ten (10) subjects with bronchial hyperreactivity and ten (10) healthy subjects. Patients with other pulmonary or cardiac disease were excluded. All received by inhalation placebo (0.9% saline solution), dopamine at 0.5 microg/kg/min (controlled by heart rate and arterial pressure with a dynamap), and placebo. Respiratory parameters: forced vital capacity (FVC), forced expiratory volume at the first second (FEV1), forced maximal expiratory flow (FEFmax) and forced expiratory flow at the 50% of vital capacity (FEF50) were measured in each protocol period. Student's paired t test, Wilcoxon and Mann Whitney analysis were performed. RESULTS: After dopamine inhalation, there was an increase of FVC by 23% (p<0.001); an increase of FEV1 by 39% (p<0.0001); an increase of FEF50 by 33% (p<0.001) and an increase of FEFmax by 31% (p<0.001). There were no respiratory parameter changes in both, subjects with bronchial hyperreactivity and normal after dopamine inhalation. CONCLUSIONS: Inhaled dopamine induces bronchodilatation in patients with crisis of bronchial asthma. Inhaled dopamine neither alters basal bronchial tone in healthy subjects nor in subjects with bronchial hyperreactivity.     

Cardiorespiratory responses to submaximal incremental exercise are not affected by one night's sleep deprivation during the follicular and luteal phases of the menstrual cycle

The purpose of the study was to investigate the effects of one night's sleep deprivation on the cardiorespiratory responses to exercise during the follicular and luteal phases of the menstrual cycle. We have studied nine, healthy females aged 24-35 years with regular menstrual cycles. Each subject performed spirometric tests at rest and then an incremental exercise testing during 11-13 days of follicular phase and 22-24 days of luteal phase following one normal night's sleep or one night's sleep loss. Compared with resting values exercise produced significant increases in cardiorespiratory variables including oxygen uptake (VO2), carbon dioxide production (VCO2), tidal volume (VT), respiratory rate (RR), minute ventilation (VE), systolic blood pressure, heart rate (HR) and respiratory quotient (R). However, it did not alter significantly diastolic blood pressure, end-tidal PO2 (PETO2), end-tidal PCO2 (PETCO2) and arterial oxygen saturation (SaO2). Spirometric variables which include forced vital capacity (FVC), forced expiratory volume in one s (FEV1), FEV1/FVC%, forced expiratory volume in three s (FEV3), forced expired flow from 25-75% of FVC (FEF 25-75%), forced expired flow at 25% of FVC (FEF 25%), forced expired flow at 50% of FVC (FEF 50%), forced expired flow at 75% of FVC (FEF 75%), forced expired flow from 75-85% of FVC (FEF 75-85%), peak expiratory flow (PEF), expiratory reserve volume (ERV), inspiratory capacity (IC) and maximal voluntary ventilation (MVV) and cardiorespiratory variables were not different between the cycle phases after one normal night's sleep or one night's sleep deprivation. Neither menstrual cycle phase nor sleep deprivation affected spirometric and cardiorespiratory parameters. We suggest that one night's sleep deprivation does not produce alterations in spirometric parameters and cardiorespiratory responses to submaximal incremental exercise during the follicular and luteal phases.     

Pulmonary functions in workers of fertiliser and chemical industry

The present study was undertaken to assess the pulmonary functions in fertiliser and chemical industry workers of Kerala. Pulmonary function test was performed with Vitalograph Compact-II spirometer. Exposure to different chemicals, noxious gases and particulate matter of fertiliser and chemical industry was injurious to the normal pulmonary function. Significant decline in lung volumes, viz. FVC, FEV1, FEV1/FVC% (P < 0.01) and flow rates, viz. FEF25-75%, FEF0.2-1.2, FEF25%, FEF50%, FEF75% (P < 0.01) among non-smokers and smokers than that of normal controls was observed. The findings of this study also suggest that with increased duration of exposure to industrial pollutants, lung volumes and flow rates were significantly reduced in workers.     

Chronically inhaled salmeterol improves pulmonary function in heart failure

Inhaled beta-agonists are commonly prescribed for the symptoms of exercise intolerance in heart failure despite a paucity of data regarding their safety and efficacy. This was a prospective, randomized, double-blind, double-dummy, placebo-controlled 14-day cross-over study to determine if chronic inhaled salmeterol therapy 84 microg every 12 hours improved pulmonary function without augmentation of neurohormonal systems or ventricular ectopy in 8 symptomatic heart failure subjects with left ventricular ejection fraction (LVEF) <40% and FEV1 相似文献   

Effects of Ranitidine on pulmonary function tests of patients with chronic obstructive pulmonary disease

Since the incidence of peptic ulcer and gastroesophageal reflux (GER) is more common in patients with chronic obstructive pulmonary disease (COPD) than normal population, H(2) receptor blockers are given more extensively to COPD patients. This study evaluated the effects of Ranitidine on pulmonary function tests (PFT) of the patients having COPD and peptic ulcer or GER, and of healthy volunteers.Fifty milligrams of Ranitidine was given intravenously to 30 COPD patients and 25 healthy volunteers. PFT were done before and 15, 30, 60, 120min after Ranitidine injection. Although mean forced vital capacity (FVC), forced expiratory volume in 1s (FEV(1)) and forced midexpiratory flow rate (FEF(25-75%)) of COPD patients were found to be decreased 60 and 120min after Ranitidine injection, the decrements were statistically insignificant. The decrements in PFT of healthy volunteers were also not statistically significant.H(2) receptor blockers can be used safely for treatment of gastrointestinal disorders in COPD patients who have mild or moderate obstruction. Minimal decreases in FEV(1) and FVC due to treatment by H(2) receptor blockers may clinically worsen COPD patients who have severe obstruction.     

Lung function development in Indian men and women during late adolescence and early adulthood--a longitudinal study

Lung function development was studied in a cohort of Indian men (n = 31) and women (n = 36), over a period of four years during late adolescence and early adulthood. Forced expiratory spirograms and peak expiratory flow rates were recorded at intervals of approximately two years. All volumes and flow rates were higher in men, but volume adjusted flow rates were higher in women. Forced vital capacity (FVC) forced expiratory volume in one second (FEV1) and peak expiratory flow (PEF) were significantly higher in men even after standardizing for age, height and weight. Height and PEF increased significantly in men and women over the four years. Volumes showed a greater increase whereas flow rates and volume adjusted flow rates showed a greater decrease in men. The decline in the forced expiratory flow in the middle half of the FVC (FEF 25-75%) was significantly less in women. These results suggest that although lung size is greater in men, small airway dynamics may be better in young women.     

Decreased expression of human aquaporin-5 correlated with mucus overproduction in airways of chronic obstructive pulmonary disease

AIM: To investigate the relationship between aquaporin-5 (AQP5) expression and mucus overproduction in the airways of Chinese patients with chronic obstructive pulmonary disease (COPD) and the correlation with pulmonary function change. METHODS: Bronchial tissues were obtained from fiberoptic bronchoscopy and bronchial biopsy in West China Hospital from April to July 2004. Twenty-five patients were diagnosed as COPD patients, and another 20 were diagnosed as the control patients. The expressions of AQP5, mucin 5AC (MUC5AC), and mucin in bronchial tissues were detected by semiquantitative RT-PCR, in situ hybridization, and immunohistochemical and alcian blue-periodic acid-Schiff (AB-PAS) staining, respectively. RESULTS: Compared with the control group, an attenuated expression of AQP5 was detected throughout the bronchial tissues from patients with COPD (P<0.01), but no difference existed in the lung tissues (P>0.05). Simultaneously, increased staining of MUC5AC and mucus in submucosal glands were noted (P<0.01, respectively). Smoking attenuated the expressions of AQP5 and increased the staining of MUC5AC and mucus in submucosal glands in the COPD groups (P<0.01), while there were no significant differences observed in the control group (P>0.05). The decreased expression of AQP5 mRNA was correlated with forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) (r=0.60, P<0.01), FEV1% predicted value (r=0.60, P<0.01), maximal expiratory flow in 50% vital capacity (V50) % predicted value (r=0.55, P<0.01), and maximal expiratory flow in 25% vital capacity (V25) % predicted value (r=0.45, P<0.01). The decreased expression was negatively correlated with MUC5AC mRNA of the epithelium airways (r=-0.45, P<0.01) and the AB-PAS-stained area of submucosal glands (r=-0.61, P<0.01). The upregulation of MUC5AC mRNA correlated with the positively AB-PAS-stained area of submucosal glands and correlated negatively with FEV1/FVC (r=-0.53; P<0.01), FEV1% predicted value (r=-0.53; P<0.01), V50% predicted value (r=-0.48; P<0.01), and V25% predicted value (r=-0.43; P<0.01). CONCLUSION: The attenuated gene expression of AQP5 existed in the airways of Chinese COPD patients, which was complicated by mucus hypersecretion. The decreased expression of AQP5 mRNA may be related to the severity of airflow obstruction.     

Evaluation of the onset and duration of response to cold air inhalation challenge in cynomolgus monkeys (Macaca fascicularis)

Cold air inhalation challenge (CAIC) for the evaluation of bronchial reactivity has been proposed as a physical agent alternative to chemical agent challenges (methacholine or histamine), especially suitable for the occupational environment. The present investigation describes and evaluates a method for performing cold air inhalation challenge in Cynomolgus monkeys (Macaca fascicularis), a species shown to be useful in animal modeling studies of occupational asthma. Six adult male anesthetized monkeys were ventilated by changes in external pressure while breathing cold air (-25 degrees C to -30 degrees C). Pulmonary function testing was performed at 10, 25, 40 and 55 min post-challenge. Significant increases (P less than 0.05) in average pulmonary flow resistance (RL) and decreases in dynamic compliance (CL dyn) were observed, with maximum impairment occurring at 25 min post-challenge, with a trend towards a return to baseline values at 55 min post-challenge. Peak expiratory flow rate (PEFR), forced expiratory volume in 0.5 s/forced vital capacity (FEV0.5/FVC) and forced expiratory flow at 50% forced vital capacity (FEF50) showed the same general pattern of reduction as seen with RL; however, these results were not statistically significant, most probably owing to individual monkey variability and the small number of monkeys (N = 6) used. A repeat challenge at 25 min after a primary challenge yielded increased RL in one monkey, suggesting that no absolute refractory period is present from CAIC. Results of these studies demonstrate that CAIC causes bronchoconstriction in monkeys and may be useful in further animal modeling studies designed to determine the asthmogenic/airway irritant potential of occupational toxicants.     

Large and small airway responses to procaterol hydrochloride administered through different extension devices in asthmatic patients.

The effects of spacer devices on the magnitude and velocity of large and small airway bronchodilator responses in asthmatic patients who can correctly operate a metered dose inhaler (MDI) remain unclear. According to a double-blinded, randomized, crossover protocol, 14 asthmatic patients were studied on seven separate occasions. On each occasion, patients inhaled doubling methacholine concentrations until forced expiratory volume in 1 second (FEV1) had fallen by 20% of baseline. Changes in forced expiratory flow between 25% and 75% of vital capacity (FEF25-75) were also evaluated. Subsequently, patients were administered 20 or 50 micrograms of procaterol from an MDI either alone or in conjunction with a small- or large-volume spacer device. Changes in FEV1 and FEF25-75 corrected for baseline forced vital capacity (isoFEF25-75) were assessed at 3-minute intervals for 15 minutes and at 30 minutes. Spontaneous recovery was similarly evaluated. The time required to attain significant increases in both FEV1 and isoFEF25-75 was calculated in bronchodilator trials. With 20 micrograms of procaterol, both spacers allowed larger and faster FEV1 increases than the MDI alone (P < 0.01); with 50 micrograms, the velocity and magnitude of FEV1 increases were further enhanced in trials with the MDI alone. The lower procaterol dose via the large-volume spacer determined larger and faster isoFEF25-75 increases than the higher dose via both the small-volume spacer and the MDI alone (P < 0.01). Spacers enhance bronchodilation even in patients using MDIs optimally. Compared with both the small-volume device and the MDI alone, the large-volume spacer allows faster and larger small airway dilation with less than half of the procaterol dose.     

Pulmonary function in patients with diabetes mellitus.

The present study was carried out to assess the lung functions in oral medicated and insulin administered patients with normal controls. 20 subjects were selected as the study group for oral medication (Group I), 20 subjects were selected as the study group for insulin treatment (Group II) and 40 subjects were selected as normal controls. Age group of Group I and Group II were 51.25 +/- 6.28 and 50.8 +/- 6.56 respectively and controls were age and height matched. Seventeen patients of Group I were undergoing treatment for the last 10-20 years and 20 patients in Group II were undergoing treatment for the last 30 years. Only male subjects were selected for the study. Lung function test were carried out with Spirometer (Vitallograph Compact II). A significant reduction in forced expiratory volume/forced vital capacity (FEV1/FVC%) was observed in oral pills used subjects and insulin administered subjects as compared to controls. Significant decrease in forced expiratory flow rate (FEF25-75%) in group I subjects was also observed as compared to controls. Forced mid flow time (FMFT) showed a significant increase in group II in comparison to controls. These changes clearly show the expiratory flow rates are reduced both in orally medicated and insulin administered patients. Increase in FMFT in group I may be due to the reduced respiratory ability to carry out the FVC test along with the side effects of oral medication for diabetes mellitus.