Uma une-asthma ebusika, ivolumu yakho yokuphefumula iphoqelekile ( FEV1 ) yehle okungenani ngamaphesenti angu-15 kusukela ngesikhathi sokulala ukuvuka ekuseni. Kwabanye, ukuncipha komsebenzi wamaphaphu kungaba ngaphezulu kakhulu. Lokhu kuhlotshaniswa nezimpawu ezikhulayo, ezifana nokukhwehlela, ukuvuthwa, nokuphefumula okuphazamisa ukulala.
Izingozi ze-Asthma yasebusuku
Iziguli ezinezinguquko ezinkulu zobusika ku-FEV1 zazo zingase zibe nezimpawu ezingaphezu kwamalanga kanye nokulawulwa kwe-asthma empofu.
Enye ephathelene neqiniso ukuthi i-asthma yesimanje ingase ihlobene nokufa kwe-asthma. Amaphesenti angu-70 okufa kanye namaphesenti angu-80 okuboshwa okuphefumula okubangelwa i-asthma kwenzeka ngesikhathi samahora ashwa. Ukuhluka okukhulu ekukhuleni kokuphefumula akuhambisani nokuqina kwesifo se-asthma kodwa kuyingozi yokuzibophezela kokubopha ukuphefumula. Iziguli eziningi ziqonda ukuthi izimpawu ezikhudlwana zihambisana nenengozi yokufa, kodwa bambalwa kakhulu abantu abaqaphela ukuhlukahluka okukhulu ekuphumeni kokuphuma kokuphefumula kokuhlwa okubangelwa yi-nocturnal okuyingxenye engozini yemiphumela embi.
Izimbangela
Ayaziwa ukuthi ukwehla komsebenzi wamaphaphu kungenxa yezinguquko zomjikelezo zomphakathi (izinguquko emsebenzini wamaphaphu ngenxa yewashi njenge-clock) noma ngabe ngandlela-thile zihlobene nokulala ngokwalo. Akuzona zonke iziguli ze-asthma, kodwa zithola izinkinga ebusuku.
Kukhona izinguquko ezithile ze-physiologic ezenzeka ngesikhathi sokulala ezingasiza ukuchaza ukuthi kungani iziguli ezithile ze-asthma zihlangabezana nezinkinga.
Ukuphikisana kuvame ukwandisa umsebenzi webusuku nomaphaphu kunciphisa njengoba isikhathi sokulala sanda. Leli qiniso lokugcina liyiqiniso ezigulini ezingenayo i-asthma, kodwa hhayi lapho zihlakulela izimpawu.
Ukuxilongwa
Indlela elula yokuthola i-asthma yebusuku ukuhlola ukugeleza kwesikhathi sokulala nokuphakama kokuphakama kokuvusa.
Uma kunokungafani kwamaphesenti angu-15 ekuphumeni kwakho kwezinga eliphakeme, unokuhluka okuphawulekayo okungenzeka kube imbangela yezibonakaliso zakho. Noma kunjalo, amamitha we-peak flow ayengacabangi kakhulu ukuthola izinguquko ze-FEV1. Wena nomhlinzeki wakho wokunakekelwa kwezempilo kungadingeka ucabangele lokhu bese uqala isilingo sokulwela .
Ucwaningo lwe-asthma luveze ukuthi abantu abangamaphesenti angama-74 abanesifo se-asthma banokuvuswa kwebusuku okungenani kanye ngesonto, kanti amaphesenti angama-64 angase abe ne-asthma ebusuku ebusuku izikhathi ezintathu noma ngaphezulu ngesonto. Okubaluleke kakhulu, abaningi abangamaphesenti angu-40 abantu abanezibalo zesifo se-asthma izimpawu ebusuku.
Abantu abane-asthma banganaki izimpawu zobusuku njengezibonakaliso zokulawulwa kwe-asthma empofu. Kwesinye isifundo, iziguli ezingamaphesenti angu-26 ahlaziya isifuba saso ngokuthi "ngomoya omnene" kubike izimpawu ze- asthma ezifana nokukhwehlela okungapheli , ukuvuthwa nokuphefumula ebusuku. Kubalulekile ukuqaphela lezi zimpawu zobusuku njengokulawulwa okubi ngoba ingxenye enkulu ye-asthma ebulalayo kubantu abadala nabantwana ababoshiwe ngokuphefumula nokufa okungazelelwe kwenzeka phakathi kwamabili no-8 ekuseni.
I-Physiology Ehamba Ne-Asthma Ebusuku
Ngesikhathi kungekho muntu owaziyo, i-asthma ebusuku ihlotshaniswe ne:
- Ukunciphisa amazinga e-nitric oxide: Ngoba i-nitric oxide iyinhlangano ye- bronchodilator enamandla, amazinga aphansi angase achaze izimpawu zobusuku obusanda.
- Ukwehlisa i-beta 2-receptors: Kokubili inombolo nomsebenzi we-beta 2 receptors-ama-receptors anesibopho se-bronchodilation evula ukuhamba kwe-airways-phakathi kwe-4: 00 no-4 ekuseni.
- Ukunciphisa ama-receptors we-steroid: Njengama-beta 2 receptors, kokubili izinombolo kanye nomsebenzi we-receptors-abhekene nokunciphisa ukuvuvukala ebusuku. Lokhu kunciphisa kungabangela ukuvuvukala okwanda ngenxa yokungabi nampendulo emzimbeni wakho ngokwe-naturally steroids noma steroids enikezwe udokotela wakho.
- Umsebenzi we-pituitary ongajwayelekile: Ukwenziwa kwe-cortisol, i-hormone eyenziwe yi-pituitary gland, iyancipha ebusuku. Lokhu ukunciphisa kuhlotshaniswa nokwehla ku- FEV1 . Ukwelapha iziguli ezinezinga eliphansi le-cortisol nge-hydrocortisone (i-steroid yokwelashwa), lihlotshaniswa nokuthuthukiswa ku-FEV1.
- I-Melatonin: Iziguli ezine-asthma zobusuku ziye zaphawula ukuthi zinamazinga aphansi okuthiwa i-melatonin uma kuqhathaniswa neziguli ezingenawo umoya wesifo sofuba.
Ukwelapha
Iningi leziguli ezine-asthma ebusuku zihlangabezana nezilinganiso njenge- asthma eqhubekayo noma ephikisanayo ngokusho kwemihlahlandlela ye-NHLBI. Kufanele uphathwe ngokuvumelana nalezi ziqondiso, kodwa wena nomhlinzeki wakho bangase bafune ukucabangela amanye amaphuzu alandelayo uma ucabanga ukuthi une-asthma yesikhombisa:
- I-glucocorticoids engenalutho: Ucwaningo oluqhathanisa ama-micrograms angu-800 (amaqhinga amane e-Azmacort inhaler) ngo-3: 00 nsuku zonke emkhakheni wendabuko we-puff eyodwa kane ngosuku, i-dosing yesithathu ekuseni isebenza kanye nezikhathi ezine ngosuku. Lapho ukuguqulwa kwaguqulwa kube ngu-8: 30 ekuseni noma ngo-5 ntambama ukuze kube lula, ukukhishwa kwansuku zonke ngo-5: 30 ntambama kwakungcono kakhulu kunokuphindaphinda izikhathi ezine ngosuku, kodwa ukusalalisa ekuseni kwakwenza okubi nakakhulu.
- Ama-agonists angama-β2 adrenergic: Ama-agonists ase- Long-acting abanjengesikhathi eside, afana ne-inhaler yakho yokuphulukisa kodwa ahlala amahora ayisithupha noma ngaphezulu njenge-salmeterol, aboniswe ukuthuthukisa umsebenzi wamaphaphu ngobusuku obubodwa, ikhwalithi yokulala, kanye nekhwalithi yonke yokuphila e-asthma.
- Ama-agonist e-Oral β2 adrenergic: Amafomu omlomo we-albuterol anikezwe njengephilisi yokukhulisa kancane kancane ekuseni ukuphakama kwamazinga okugeleza okuphefumulayo nokunciphisa ukushisa nokuphefumula.
- Theophylline: Izinhlobo ezahlukene ze theophylline zinezinto ezihlukile. Enye engasiza ikakhulukazi i-asthma yebusuku kuyilungiselelo elenzelwe ukuba namazinga aphezulu ebusuku-afana ne-Uniphyl-uma uhlangabezana nezimpawu eziningi. Ngalolu hlobo, ama- theophylline ancipha ngesikhathi sosuku futhi iziguli zithola imiphumela emibi kakhulu kunezingqinamba zendabuko.
- Ukwelashwa kweminye imibandela eyenza i-asthma ibe yingozi kakhulu : Ezinye izimo zezokwelapha, njenge-reflux yesisu, izinkinga zesinus , nokukhuluphala, kungase kube nzima kakhulu nge-asthma yakho. Uma unesimiso se-asthma sebusuku , qiniseka ukuthi awusengozini yalezi zimo.
Imithombo:
> I-Ginsberg D. I-Monster engaziwa embhedeni - Ukuhlola I-Asthma Ebusuku Ezinganeni. I-McGill Journal of Medicine: MJM . 2009; 12 (1): 31-38.
> Martin RJ. I-Asthma yasebusuku. Kusesikhathini. https://www.uptodate.com/contents/nocturnal-asthma.