Diagnostic Value of Wheezes Detected on the Neck of Asthmatics during Quiet Expiration below Functional Residual Capacity

概要

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We tried to auscultate "wheezes" on the necks of 62 asthmatic patients during quiet tidal breathing and following slow expiration to the maximal expiratory level, to evaluate its clinical usefulness and pathophysiological significance. The subjects could be classified into the following four "Grades" according to the lung volume where wheezes became audible on the neck. In 24 out of 62 patients (Grade I), no wheeze could be auscultated during expiration to RV level, whereas in 33 patients it was observed during either early (Grade III) or late (Grade II) phase of expiration of expiratory reserve volume. In 5 patients (Grade IV) wheeze was audible even during tidal breathing. The rate of forced expiratory volume in one second (FEV_1%) had close correlation (r=-0.774) to the above "Grade" classifications, which decreased significantly from Grade I to Grade IV. Although it correlated consistently (r=+0.656) to above classified Grades, severity of the asthmatics showed a poor correlation to FEV_1%. We conclude that auscultation of wheezes on the neck below FRC level as well as the grading according to the lung volume where wheezes become audible could be simple clinical means, which estimate objectively both airway obstruction and severity of symptoms in the patients with asthma.
北里大学の論文
1987-12-31