Abstract：
BACKGROUND: Patients with severe asthma often have uncontrolled disease and experience mood disorders, particularly anxiety and depression. The autonomic nervous system (ANS) plays an important role in asthma, mainly through the parasympathetic ANS system (PANS), which favors bronchoconstriction and mental health status.
OBJECTIVE: To evaluate the role of the activation of the PANS in uncontrolled asthma and related mood disorders.
METHODS: This was a proof-of-concept cross-sectional study that analyzed demographic and clinical variables reflecting asthma severity and control, lung function, inflammation (from induced sputum), evaluation of quality of life, and the risk for anxiety and depression according to validated questionnaires. The PANS analysis was conducted based on heart rate variability: SD of the difference between consecutive normal-to-normal (NN) intervals (SDNN), root mean square of the successive differences (RMSSD), percentage of consecutive NN intervals (pNN50), total power (TP), and respiratory-related power (Pr).
RESULTS: A total of 30 patients with asthma were grouped according to asthma control and the risk for anxiety and depression; 10 patients with uncontrolled asthma compared with the patients with controlled asthma showed significant differences (P < .05) in SDNN (26.5 [8.2] vs 42.7 [29.7]), RMSSD (14.1 [6.5] vs 24 [20]), pNN50 (0.6 [1.5] vs 6.2 [11.8]), TP (0.0005 [0.00046] vs 0.0014 [0.00085]), and Pr (0.0003 [0.00025] vs 0.0007 [0.00060]) respectively. A total of 13 patients at risk for anxiety and depression compared with the patients without showed reduced values (P < .05) for SDNN (26.5 [7.9] vs 45.6 [31.3]), pNN50 (0.75 [1.4] to 7.12 [12.6]), TP (0.0005 [0.00048] to 0.0012 [0.0008]), and Pr (0.0003 [0.00027] to 0.0008 [0.00062]).
CONCLUSIONS: Our results suggest that PANS activity is depressed in patients with uncontrolled asthma and common mood disorders such as depression and anxiety, and the evaluation of heart rate variability may be a useful means for follow-up of asthma control and related mood disorders.
OBJECTIVE: To evaluate the role of the activation of the PANS in uncontrolled asthma and related mood disorders.
METHODS: This was a proof-of-concept cross-sectional study that analyzed demographic and clinical variables reflecting asthma severity and control, lung function, inflammation (from induced sputum), evaluation of quality of life, and the risk for anxiety and depression according to validated questionnaires. The PANS analysis was conducted based on heart rate variability: SD of the difference between consecutive normal-to-normal (NN) intervals (SDNN), root mean square of the successive differences (RMSSD), percentage of consecutive NN intervals (pNN50), total power (TP), and respiratory-related power (Pr).
RESULTS: A total of 30 patients with asthma were grouped according to asthma control and the risk for anxiety and depression; 10 patients with uncontrolled asthma compared with the patients with controlled asthma showed significant differences (P < .05) in SDNN (26.5 [8.2] vs 42.7 [29.7]), RMSSD (14.1 [6.5] vs 24 [20]), pNN50 (0.6 [1.5] vs 6.2 [11.8]), TP (0.0005 [0.00046] vs 0.0014 [0.00085]), and Pr (0.0003 [0.00025] vs 0.0007 [0.00060]) respectively. A total of 13 patients at risk for anxiety and depression compared with the patients without showed reduced values (P < .05) for SDNN (26.5 [7.9] vs 45.6 [31.3]), pNN50 (0.75 [1.4] to 7.12 [12.6]), TP (0.0005 [0.00048] to 0.0012 [0.0008]), and Pr (0.0003 [0.00027] to 0.0008 [0.00062]).
CONCLUSIONS: Our results suggest that PANS activity is depressed in patients with uncontrolled asthma and common mood disorders such as depression and anxiety, and the evaluation of heart rate variability may be a useful means for follow-up of asthma control and related mood disorders.
摘要：
背景：重度哮喘患者通常患有不受控制的疾病并经历情绪障碍，尤其是焦虑和抑郁。自主神经系统在哮喘中发挥着重要作用,主要通过副交感神经系统（PANS），这有利于支气管收缩和心理健康状况。
目的：评价PANS激活在哮喘未控制和心境障碍相关中的作用。
方法：概念验证横断面研究，分析反映哮喘严重程度和控制的人口统计学和临床变量，肺功能,炎症（来自诱导痰），生活质量评估，根据经过验证的问卷，焦虑和抑郁的风险。根据心率变异性（HRV）进行PANS分析：SDNN（连续NN间隔之间差异的标准偏差），RMSSD(连续差的均方根)，pNN50（连续NN间隔的百分比），TP（总功率），和Pr(呼吸相关功率)。
结果：30名哮喘患者，根据哮喘控制和焦虑和抑郁风险分组。10例未控制的哮喘患者与控制的哮喘患者相比，SDNN（26.5[8.2]vs42.7[29.7]）存在显着差异（p<0.05），RMSSD（14.1[6.5]对24[20]），pNN50（0.6[1.5]对6.2[11.8]），TP（0.0005[0.00046]对0.0014[0.00085]），和Pr(分别为0.0003[0.00025]对0.0007[0.00060])。与无焦虑和抑郁风险的患者相比，有13例患者的SDNN值降低（p<0.05）（26.5[7.9]vs45.6[31.3]），pNN50(0.75[1.4]至7.12[12.6])，TP(0.0005[0.00048]至0.0012[0.0008]),和Pr(0.0003[0.00027]至0.0008[0.00062])。
结论：我们的研究结果表明，PANS活性在未控制的哮喘和常见的情绪障碍如抑郁和焦虑的患者中降低，HRV的评估可能是哮喘控制和相关情绪障碍随访的有用手段。
目的：评价PANS激活在哮喘未控制和心境障碍相关中的作用。
方法：概念验证横断面研究，分析反映哮喘严重程度和控制的人口统计学和临床变量，肺功能,炎症（来自诱导痰），生活质量评估，根据经过验证的问卷，焦虑和抑郁的风险。根据心率变异性（HRV）进行PANS分析：SDNN（连续NN间隔之间差异的标准偏差），RMSSD(连续差的均方根)，pNN50（连续NN间隔的百分比），TP（总功率），和Pr(呼吸相关功率)。
结果：30名哮喘患者，根据哮喘控制和焦虑和抑郁风险分组。10例未控制的哮喘患者与控制的哮喘患者相比，SDNN（26.5[8.2]vs42.7[29.7]）存在显着差异（p<0.05），RMSSD（14.1[6.5]对24[20]），pNN50（0.6[1.5]对6.2[11.8]），TP（0.0005[0.00046]对0.0014[0.00085]），和Pr(分别为0.0003[0.00025]对0.0007[0.00060])。与无焦虑和抑郁风险的患者相比，有13例患者的SDNN值降低（p<0.05）（26.5[7.9]vs45.6[31.3]），pNN50(0.75[1.4]至7.12[12.6])，TP(0.0005[0.00048]至0.0012[0.0008]),和Pr(0.0003[0.00027]至0.0008[0.00062])。
结论：我们的研究结果表明，PANS活性在未控制的哮喘和常见的情绪障碍如抑郁和焦虑的患者中降低，HRV的评估可能是哮喘控制和相关情绪障碍随访的有用手段。
