Psychological status in uncontrolled asthma is not related to airway hyperresponsiveness.

BACKGROUND: Airway hyperresponsiveness (AHR) is the characteristic functional abnormality of asthma, and previous studies have shown the potential for AHR to be influenced by psychological factors, yet the relationship between anxiety and/or depression and AHR remains unclear in patients with asthma. OBJECTIVE: To explore the relationship between psychological status and AHR in asthma patients. METHODS: In a cross-sectional study, 168 adult subjects were recruited with physician-diagnosed uncontrolled asthma and a positive result for AHR in methacholine (Mch) challenge test. Psychological status, asthma control, and asthma quality of life were assessed using Zung self-rating anxiety/depression scale, asthma control test (ACT), and asthma quality of life questionnaire (AQLQ), respectively. AHR severity was evaluated and quantified by the provocative concentration of Mch, which evoked a given decrease of 20% in FEV(1). RESULTS: A total of 70.23% of recruited patients (n = 118) met the diagnostic criteria for anxiety and/or depression. There was a trend between negative psychological status and AHR in asthma patients that did not reach statistical significance, but no independent effects of negative mood states (anxiety, depression, or both) on AHR were established. Further, analyses revealed that only anxiety is associated with worse asthma control (p = 0.029), and a significant interaction effect of depression and anxiety accounted for lower asthma-related quality-of-life scores (p < 0.001). CONCLUSIONS: AHR and psychological status are loosely related to each other even if in uncontrolled asthma.

[Bronchial hyperreactivity in endobronchial tuberculosis].

OBJECTIVE: To investigate the bronchial hyperreactivity (BHR) and pulmonary function in patients suffering from endobronchial tuberculosis (EBTB), and therefore to provide clues for early and correct diagnosis of EBTB. METHODS: Twenty-four patients with EBTB, proved by fiberoptic bronchoscopy, chest computerized tomography and biopsy, received measurements of pulmonary ventilatory function, airway resistance (Raw), and bronchial responsiveness test. The results were analyzed by t test and correlations. RESULTS: As many as 41.7% of the patients with EBTB were found to have BHR, which had never been recognized before. The patients with EBTB usually had severe cough (100%, 24/24), shortness of breath (54%, 13/24), and wheezing, but bloody sputum was found in only 21% (5/24), and so the patients tended to be misdiagnosed as having asthma, especially cough variant asthma. FEV(1%) in the group of EBTB with BHR was significantly higher than that in the group of EBTB without BHR (t = 2.345, P < 0.05). But there was no significant difference of FEV(1)/FVC%, MMEF%, V(75%) and Raw between the two groups. In the group of EBTB with BHR, FEV(1%) showed a negative correlation with BHR (r = -0.61, P < 0.05), but there was no remarkable correlation between the other pulmonary function parameters with BHR. CONCLUSION: BHR is present in a considerable number of patients with EBTB, and therefore attention should be paid to the differential diagnosis of EBTB and cough variant asthma.