向编辑:
吞咽是分离气道和食道的重要功能。这种机制的功能障碍可能导致致病性口咽含量的吸入。可以通过简单的两步吞咽挑衅试验(STS-SPT)和重复唾液吞咽测试(RSST)来评估吞咽功能的疾病1,2。筛查测试都是安全的,快速和低成本。最近,据报道,吞咽功能障碍可能是加剧慢性阻塞性肺病(COPD)的危险因素3。Therefore, detection of the swallowing dysfunction at an earlier stage of COPD may be very important in management of COPD patients and to prevent advancing stages of the disease. Swallowing dysfunction in advancing stages of COPD has been reported3,4。However, it is unclear whether swallowing functions are disordered in primary COPD. The present study was conducted to elucidate swallowing function before exacerbation of COPD, especially at a mild stage, as defined by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification5,使用STS-SPT和RSST。本对应的是对调查加剧概率的前瞻性研究的初步。
六十四名患者(50名男性和14名女性),诊断COPD(1 S中强迫呼气量(FEV1)/forced vital capacity <70%), who had experienced no exacerbation, were recruited from the outpatient clinic of Toyohashi Municipal Hospital, Toyohashi, Japan. Patients with cerebrovascular accident neuromyopathy and previous head and neck surgery were excluded. Ethical approval was obtained from the hospital and informed consent was obtained from all study subjects and controls.
The COPD patients were divided into the following three groups. 1) FEV1≥80%pred:mild;2)50%≤fev1<80%pred:中等;3)30%≤fev1<50% predicted: severe. Fifteen healthy subjects (six male and nine female) were recruited as a control group. The age of all of subjects was 73.2±3.6 yrs (n = 79), and was not significantly different among the groups. All subjects underwent the STS-SPT and the RSST. In the STS-SPT, the subject was estimated as having abnormal swallowing when the swallowing response was not triggered within 3 s after a bolus injection of 2.0 mL of distilled water at the suprapharynx through a nasal catheter. In the RSST, swallowing function of the subject was estimated as abnormal when the number of saliva swallowings was less than three events during 30 s. The data were analysed by Fisher's exact test. When significant effects were found at a 1% level, Tukey's multiple-range test was used.
在COPD的中度和严重的阶段,STS-SPT估计的正常吞咽患者的比例高于对照组。相比之下,RSST评估了COPD温和阶段异常对正常吞咽患者的比率高于对照;这也是中度和严重的群体的情况(表1⇓)。然而,COPD阶段之间的比例没有显着差异。
通过简单的两步吞咽挑衅试验(STS-SPT)估计的异常吞咽患者的数量和慢性阻塞性肺病(COPD)的各个阶段的重复唾液吞咽试验(RSST)
The present results may suggest that both the STS-SPT and the RSST can be used to evaluate swallowing dysfunction before an exacerbation of COPD occurs and, furthermore, the RSST may even be valid at the mild stage of COPD. The present study also suggests that the swallowing dysfunction in COPD may begin in the mild stage and, therefore, aspiration should be monitored from the mild stage in COPD patients. For cost–performance purposes, medical treatment of COPD patients is necessary at an earlier stage. The present study shows that is is possible to identify subjects who are at risk of developing COPD by an easy, low-cost method in a primary stage of the disease. Furthermore, the present correspondence could be developed as a study investigating the probability of exacerbation in COPD.
Statement of interest
没有宣布。
致谢
作者感谢K. Oshima进行数据分析。
- ©ers Journals Ltd