Ngati muli ndi mphumu yausiku, mphamvu yanu yofufuzira ( FEV1 ) imachepetsa ndi 15 peresenti kuyambira nthawi yogona kuti mukadzuka m'mawa. Kwa ena, kuchepa kwa mapapu kumatha kukhala kwambiri. Izi zimagwirizanitsidwa ndi zizindikiro zowonjezera, monga chifuwa, kupuma, ndi kupuma komwe kumasokoneza tulo.
Zowopsa za Mphumpho ya Nocturnal
Odwala omwe amasintha nthawi zambiri usiku wawo FEV1 angakhalenso ndi zizindikiro zambiri zamasana komanso kulamulira kovuta kwa asthma.
Wina wokhudzana ndi zenizeni ndikuti mphumu ya usiku imatha kugwirizana ndi kufa kwa mphumu. Ambiri makumi asanu ndi awiri mwa anthu 100 alionse omwe amamwalira ndi 80 peresenti ya kumangidwa kwa mphumu kumachitika usiku. Kusiyanasiyana kwakukulu kwa kuthamanga kwapakati pazomwe sikunagwirizanitsidwe ndi chifuwa cha mphumu koma ndi kudziimira payekha chifukwa cha kumangirira kupuma. Odwala ambiri amadziwa kuti zizindikiro zoopsa zimakhala ndi chiopsezo chochuluka cha imfa, koma anthu owerengeka kwambiri amadziwa kusiyana kwakukulu kwa madontho akuluakulu a ziwalo zakuthambo zomwe zimakhala zovuta chifukwa cha zotsatira zosauka.
Zimayambitsa
Sitikudziwika ngati kuchepa kwa mapapu kumagwira ntchito chifukwa cha kusintha kwa kayendedwe kake (kusintha kwa mapapu kumagwira ntchito chifukwa cha chilengedwe monga koloko) kapena ngati pali njira inayake yokhudzana ndi kugona. Si odwala onse a mphumu, komabe amakumana ndi mavuto usiku.
Pali kusintha kwa thupi komwe kumachitika pa tulo komwe kungathandize kumvetsa chifukwa chake odwala a mphumu amavutika.
Kukanika kumawonjezeka usiku ndi m'mapapo ntchito imachepetsedwa pamene nthawi yogona ikuwonjezeka. Mfundo yomalizirayi ndi yoona kwa odwala omwe alibe mphumu, koma osati pomwe akukhala ndi zizindikiro.
Kudziwa
Njira yosavuta yodziŵiratu kuti mphumu yotsutsana ndi usiku ndiyo kuyang'ana nthawi yopuma ikukwera ndipo chiwongolero chimatuluka pa kuwuka.
Ngati pali kusiyana kwakukulu kwa magawo 15 peresenti pa chivomezi chanu, muli ndi kusiyana kwakukulu komwe kungayambitse zizindikiro zanu. Komabe, chiwerengero cha mamita othamanga sichimveka kwambiri kuti chizindikire kusintha kwa FEV1. Inu ndi wothandizira zaumoyo wanu mungafunikire kulingalira izi ndikuyambitsa mayesedwe ochiritsira .
Kafukufuku wofufuza za mphumu wasonyeza kuti anthu 74 peresenti ya anthu omwe ali ndi mphumu amakhala ndi usiku kamodzi pa sabata, pomwe 64 peresenti amakhala ndi mphumu usiku katatu kapena kuposerapo pa sabata. Chofunika kwambiri, pafupifupi 40 peresenti anthu omwe ali ndi chifuwa cha mphumu zizindikiro usiku.
Anthu omwe ali ndi mphumu akhoza kunyalanyaza zizindikiro za usiku monga chizindikiro cha kuchepa kwa mphumu . Mu phunziro lina, 26 peresenti ya odwala omwe adafufuzira mphumu yawo ngati "yofatsa" omwe akudwala zizindikiro za mphumu monga chifuwa chachikulu , kupuma, ndi kupuma pang'ono usiku. Ndikofunika kuzindikira kuti zizindikiro za usikuzi ndizosalamulirika chifukwa chakuti matenda akuluakulu ambiri omwe amafa ndi akuluakulu ndi ana omwe amamangidwa chifukwa chakumangirira ndi kufa mwadzidzidzi kumafika pakati pa usiku ndi 8 koloko m'mawa.
Physiology Pambuyo pa Nofiurnal Pumupumu
Ngakhale palibe amene akudziwa, mphumu usiku wagwirizanitsidwa ndi:
- Kuchepetsa nitric okusayidi m'magawo: Chifukwa nitric oxide ndipamwamba kwambiri bronchodilator , miyeso ya kuchepa ingathe kufotokoza kuwonjezeka kwa zizindikiro za usiku.
- Kuchepetsa beta 2-receptors: Nambala ndi ntchito ya beta 2 receptors-zotengera zomwe zimayambitsa bronchodilation yomwe imatsegula mpweya wanu pakati pa 4pm ndi 4pm
- Kuchepetsa steroid receptors: Mofanana ndi beta 2 receptors, mawerengero ndi ntchito ya steroid receptors-omwe amachititsa kuchepa kutentha-kuchepa usiku. Kuchepa kumeneku kungakhale kotheka chifukwa cha kuchepa kwa matupi anu mwachibadwa steroid kapena steroids zomwe dokotala wanu akukuuzani.
- Ntchito yopanda ntchito: Kupanga cortisol, mahomoni opangidwa ndi chifuwa cha pituitary, imatha usiku wonse. Kuchepetsa uku kukugwirizana ndi kuchepa kwa FEV1 . Kuchiza odwala omwe ali ndi ma cortisol otsika ndi hydrocortisone (mankhwala ochiritsira steroid), amagwirizana ndi kusintha kwa FEV1.
- Melatonin: Odwala omwe ali ndi mphumu yausiku amadziwika kuti ali ndi mavalo otsika a melatonin poyerekeza ndi odwala omwe alibe mphumu ya mphuno.
Chithandizo
Odwala ambiri omwe ali ndi mphumu usiku amakumana ndi zizindikiro monga zovuta kapena zovuta zokhudzana ndi mphumu malinga ndi malangizo a NHLBI. Muyenera kulandira chithandizo motsatira ndondomeko izi, koma inu ndi wothandizira anu mungafunike kuganizira mfundo zotsatirazi ngati mukuganiza kuti muli ndi mphumu ya usiku:
- Kuphatikizidwa mu glucocorticoids: Pa kafukufuku poyerekeza ndi micrograms 800 (mawonekedwe anayi a Azmacort inhaler) 3 koloko tsiku lililonse ku chizolowezi cha chikhomo chimodzi patsiku, 3 koloko madzulo amagwira ntchito komanso nthawi zinayi patsiku. Pamene dosing inasinthidwa kukhala 8:30 am kapena 5 koloko masana, nthawi imodzi tsiku lililonse 5:30 pm dosing idakali bwino kuposa nthawi zinayi pa tsiku, koma m'mawa kwambiri dosing anachita kwambiri.
- Kugulitsidwa kwa β2 adrenergic agonists: Kuchita nthawi yaitali β2 agonists, mofanana ndi kupulumutsa kwanu mu inhaler koma kumatenga maola asanu ndi limodzi kapena ochulukirapo monga salmeterol, awonetsedwa kuti apangitse mapapu kugwira ntchito usiku, ubwino wa kugona, ndi umoyo wonse mu mphumu ya usiku.
- Mankhwala ovomerezeka a Oral β2 adrenergic: Mankhwala amtundu wa albuterol omwe amaperekedwa ngati pulogalamu ya pulogalamu yopanda pang'onopang'ono amawonjezereka m'mawa kwambiri ndipo amachepetsa kupuma ndi kupuma pang'ono.
- Theophylline: Theophylline zosiyanasiyana zimakhala ndi katundu wosiyana. Chimodzi chomwe chingathandize makamaka mphumu yam'mawa ndi kukonzekera kukonzekera kukhala ndi maulendo apamwamba usiku-monga Uniphyl-pamene muli ndi zizindikiro zambiri. Ndi regimen iyi, ma theophylline amachepa masana ndipo odwala amakhala ndi zotsatira zochepa kusiyana ndi mwambo wa chikhalidwe.
- Kuchiza kwa zinthu zina zomwe zimakhala zovuta kwambiri mphumu : Zochitika zina zamankhwala, monga mimba yakusakaniza, mavuto a uchimo , ndi kunenepa kwambiri, zingawononge mphumu yako. Ngati muli ndi zizindikiro za mphumu zakutchire , onetsetsani kuti simuli pangozi chifukwa cha izi.
Zotsatira:
> Ginsberg D. Chirombo Chosazindikiritsidwa Pogona - Kufufuza Kuthandizira Kwasana kwa Ana. McGill Journal of Medicine: MJM . 2009; 12 (1): 31-38.
> Martin RJ. Mphumpho ya Nocturnal. Zaposachedwa. https://www.uptodate.com/contents/nocturnal-asthma.