n.

喘鳴
(胸部の聴診所見。呼吸音)笛音
ぜいぜい言う音、ぜいぜい言うこと

vt.

～をぜいぜいさせて言う

関: stridor, wheezing

<youtube>https://www.youtube.com/watch?v=VA9C_aCH7F0</youtube>

WordNet

breathe with difficulty
breathing with a husky or whistling sound
(Briticism) a clever or amusing scheme or trick; "a clever wheeze probably succeeded in neutralizing the German espionage threat"
a whistling sound when breathing (usually heard on inspiration); indicates obstruction of the trachea or larynx

PrepTutorEJDIC

〈ぜんそくの人などが〉ゼーゼー(ヒーヒー)と息をする / 〈車などが〉ゼーゼー(ヒーヒー)という音を立てる / …‘を'ゼーゼー息を切らして言う《+out+『名』,+『名』+out》 / ゼーゼーすること;その音 / 《俗》冗談;いたずら

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/03/14 06:31:25」(JST)

wiki en

[Wiki en表示]

	Wheezing The sound of wheezing as heard with a stethoscope.
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A wheeze (formally called "sibilant rhonchi" in medical terminology) is a continuous, coarse, whistling sound produced in the respiratory airways during breathing. For wheezes to occur, some part of the respiratory tree must be narrowed or obstructed, or airflow velocity within the respiratory tree must be heightened. Wheezing is commonly experienced by persons with a lung disease; the most common cause of recurrent wheezing is asthma attacks, though it can also be a symptom of lung cancer.

The differential diagnosis of wheezing is wide, and the cause of wheezing in a given patient is determined by considering the characteristics of the wheezes and the historical and clinical findings made by the examining physician.

Characteristics[edit]

Wheezes occupy different portions of the respiratory cycle depending on the site of airway obstruction and its nature. The fraction of the respiratory cycle during which a wheeze is produced roughly corresponds to the degree of airway obstruction.^[1]^[2] Bronchiolar disease usually causes wheezing that occurs in the expiratory phase of respiration. The presence of expiratory phase wheezing signifies that the patient's peak expiratory flow rate is less than 50% of normal.^[3] Wheezing heard in the inspiratory phase on the other hand is often a sign of a stiff stenosis, usually caused by tumors, foreign bodies or scarring. This is especially true if the wheeze is monotonal, occurs throughout the inspiratory phase (i.e. is "holoinspiratory"), and is heard more proximally, in the trachea. Inspiratory wheezing also occurs in hypersensitivity pneumonitis.^[4] Wheezes heard at the end of both expiratory and inspiratory phases usually signify the periodic opening of deflated alveoli, as occurs in some diseases that lead to collapse of parts of the lungs.

The location of the wheeze can also be an important clue to the diagnosis. Diffuse processes that affect most parts of the lungs are more likely to produce wheezing that may be heard throughout the chest via a stethoscope. Localized processes, such as the occlusion of a portion of the respiratory tree, are more likely to produce wheezing at that location, hence the sound will be loudest and radiate outwardly. The pitch of a wheeze does not reliably predict the degree of narrowing in the affected airway.^[5]

A special type of wheeze is stridor. Stridor — the word is from the Latin, strīdor^[6] — is a harsh, high-pitched, vibrating sound that is heard in respiratory tract obstruction. Stridor heard solely in the expiratory phase of respiration usually indicates an upper respiratory tract obstruction, "as with aspiration of a foreign body (such as the fabled pediatric peanut)."^[7] Stridor in the inspiratory phase is usually heard with obstruction in the upper airways, such as the trachea, epiglottis, or larynx; because a block here means that no air may reach either lung, this condition is a medical emergency. Biphasic stridor (occurring during both the inspiratory and expiratory phases) indicates narrowing at the level of the glottis or subglottis, the point between the upper and lower airways.

Diagnosis[edit]

1 out of 3 preschool children and 2 out of 3 school children with recurrent wheezing/coughing are allergic.^{[citation needed]} . The reaction creates an inflammation which, in turn, can lead to a variety of symptoms such as wheezing.

Over the last decade allergy has increased by 18% in the United States.^[8] Today one child in four is allergic.^{[citation needed]} Early diagnosis of allergy is important for the development of the child later in life.^{[citation needed]} There are many patients with symptoms suggesting eczema, rhinitis, hay fever, asthma or wheezing.

References[edit]

^ Baughman RP, Loudon RG (Nov 1984). "Quantitation of wheezing in acute asthma" (– ^{Scholar search}). Chest 86 (5): 718–22. doi:10.1378/chest.86.5.718. PMID 6488909. ^{[dead link]}
^ Pasterkamp H, Tal A, Leahy F, Fenton R, Chernick V (Jul 1985). "The effect of anticholinergic treatment on postexertional wheezing in asthma studied by phonopneumography and spirometry". Am Rev Respir Dis. 132 (1): 16–21. PMID 3160273.
^ Shim CS, Williams MH (May 1983). "Relationship of wheezing to the severity of obstruction in asthma". Arch Intern Med. 143 (5): 890–2. doi:10.1001/archinte.143.5.890. PMID 6679232.
^ Earis JE, Marsh K, Pearson MG, Ogilvie CM (Dec 1982). "The inspiratory "squawk" in extrinsic allergic alveolitis and other pulmonary fibroses". Thorax 37 (12): 923–6. doi:10.1136/thx.37.12.923. PMC 459459. PMID 7170682.
^ Meslier N, Charbonneau G, Racineux JL (Nov 1995). "Wheezes". Eur Respir J. 8 (11): 1942–8. doi:10.1183/09031936.95.08111942. PMID 8620967.
^ Simpson JA, Weiner ESC (eds). "stridor, n. 2." Oxford English Dictionary 2nd ed. Oxford: Clarendon Press, 1989. OED Online Oxford University Press. Accessed September 10, 2005. http://dictionary.oed.com.
^ Sapira JD, Orient JM (2000). Sapira's art & science of bedside diagnosis (2nd ed.). Hagerstwon, MD: Lippincott Williams & Wilkins. ISBN 0-683-30714-2.
^ Park, Alice (2009-02-26). "Why We're Going Nuts Over Nut Allergies - TIME". Time. Retrieved 2 March 2009.

UpToDate Contents

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1. 小児の喘鳴へのアプローチ approach to wheezing in children
2. 成人における喘息以外の喘鳴をきたす疾患の評価 evaluation of wheezing illnesses other than asthma in adults
3. ウイルス誘発性の喘鳴および喘息：概要 virus induced wheezing and asthma an overview
4. 小児における喘息以外の喘鳴疾患 wheezing illnesses other than asthma in children
5. 幼児における再発するウイルス誘発性喘鳴の治療 treatment of recurrent virus induced wheezing in young children

English Journal

Computerized analysis of respiratory sounds during COPD exacerbations.

Sánchez Morillo D, Astorga Moreno S, Fernández Granero MÁ, León Jiménez A.SourceBiomedical Engineering and Telemedicine Researching Group, University of Cádiz, Cádiz 11003, Spain. Electronic address: daniel.morillo@uca.es.
Computers in biology and medicine.Comput Biol Med.2013 Aug 1;43(7):914-21. doi: 10.1016/j.compbiomed.2013.03.011. Epub 2013 Apr 6.
Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is a major event in the natural course of the disease, and is associated with significant mortality and socioeconomic impact. Abnormal respiratory sounds are commonly present in patients with AECOPD. Computerized analysis of these
PMID 23746734

From sneeze to wheeze: What we know about rhinovirus Cs.

Miller EK, Mackay IM.SourceDepartment of Pediatrics, Division of Allergy, Immunology, and Pulmonary Medicine, Vanderbilt University Medical Center, Nashville, TN, United States. Electronic address: eva.k.miller@vanderbilt.edu.
Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology.J Clin Virol.2013 Aug;57(4):291-9. doi: 10.1016/j.jcv.2013.04.015. Epub 2013 May 25.
While the discovery of HRV-Cs is recent, there are no indications that they are new viruses, or that they are emerging in real-time. Genetically, HRV-Cs are most closely related to the members of HRV-A and HRV-B but even a small genetic difference can impart encompass significant changes to their cl
PMID 23714395

Sickle-cell disease in Malawian children is associated with restrictive spirometry: a cross-sectional survey.

Cook J, Jefferis O, Matchere P, Mbale E, Rylance J.AbstractBACKGROUND: A proportion of children with sickle-cell disease (SCD) demonstrate clinical findings consistent with the diagnosis of asthma. These children are at increased risk of complications, including acute chest syndrome.OBJECTIVE: To assess lung function and symptoms of asthma in children with SCD in Blantyre, Malawi.DESIGN: Twenty-five children aged 7-16 years with electrophoretically confirmed SCD were recruited to u ndergo spirometry and questionnaire screening of asthma symptoms. Forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC) and FEV1/FVC ratio were compared with local and international reference ranges. Symptoms were assessed using the International Study of Asthma and Allergies in Childhood questionnaire.RESULTS: Mean spirometric indices, represented as Z-scores derived from international reference ranges, were low: FEV1 -1.64 (95%CI -2.04 to -1.23), FVC -1.49 (95%CI -1.90 to -1.09), FEV1/FVC -0.39 (95%CI -0.76 to -0.03). Comparison with local reference ranges, represented as percentage of predicted value, revealed similar impairments: FEV1 86.9 (95%CI 81.1 to 92.7), FVC 89.0 (95%CI 83.5 to 94.4), FEV1/FVC ratio 97.7 (95%CI 95.4 to 99.9). The prevalence of wheeze was 16.7%.CONCLUSION: We present spirometric abnormalities suggestive of restrictive lung disease with no evidence of obstructive defects or increased prevalence of wheeze.
The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease.Int J Tuberc Lung Dis.2013 Jul 3. [Epub ahead of print]
BACKGROUND: A proportion of children with sickle-cell disease (SCD) demonstrate clinical findings consistent with the diagnosis of asthma. These children are at increased risk of complications, including acute chest syndrome.OBJECTIVE: To assess lung function and symptoms of asthma in children with
PMID 23827770

Japanese Journal

乳幼児期の喘鳴の鑑別診断と治療

荒川浩一
日本医事新報 -(4592) (-), 71-75, 2012-04-28
NAID 40019229720

乳幼児の喘鳴に対するロイコトリエン受容体拮抗薬使用の是非 : Conの立場から (特集アレルギー治療のPro&Con)

吉原重美
臨床免疫・アレルギー科 57(4), 411-417, 2012-04
NAID 40019309760

乳幼児の喘鳴に対するロイコトリエン受容体拮抗薬使用の是非 : Proの立場から (特集アレルギー治療のPro&Con)

藤澤隆夫
臨床免疫・アレルギー科 57(4), 405-410, 2012-04
NAID 40019309754

Related Pictures

★リンクテーブル★

リンク元	「喘鳴」「呼吸音」「笛音」「stridor」「高音性連続性ラ音」

「喘鳴」

Wheezing
ICD-10	R06.2
ICD-9	786.07
MedlinePlus	003070

　　[★]

英: wheezing, wheeze, stridor, harsh, grating sound
同: 狭窄音 stenotic sound
関: ラ音、呼吸音

概念

広義：聴診器なしに聴かれる異常呼吸音
狭義：聴診上、高音(400Hz以上)で連続性(0.25秒以上続く)の副雑音

定義：weezeとstridor

wheeze

a wheeze is a musical and continuous sound that originates from oscillations in narrowed airways (NEL.1773)

wheezing is heard mostly on expiration as a result of critical airway obstruction

stridor (NEL.1773)

when obstruction occurs in the extrathoracic airways during inspiration, the noise is reffered to as stridor (NEL.1773)
吸気時喘鳴、吸気性喘鳴、inspiratory stridorとも記載されうる。

吸気時により著明なで、上気道・中枢気道狭窄による喘鳴

喘鳴を来す疾患

呼気時の喘鳴

気管支喘息

etc.

吸気時の喘鳴

気道感染
先天性

喉頭無力症、気管無力症、喉頭・気管奇形

喉頭・気管嚢腫瘍

甲状舌管嚢胞、乳頭症

神経性

反回神経麻痺、分娩障害

圧迫による気管狭窄

巨舌症、頚部腫瘍、食道癌

喉頭浮腫

血管神経性、機械的刺激、全身浮腫

喉頭痙攣

テタニー、Gaucher病、機械的刺激

喉頭・気管異物

小児の喘鳴

SPE.300

	急性喘鳴	反復性喘鳴
乳児 2歳未満	急性細気管支炎気管支炎・肺炎食物アレルギーによるアナフィラキシークループ食道異物	乳児喘息喉頭軟化症・気管支軟化症慢性肺疾患（新生児期の呼吸器障害後) 先天異常による気道狭窄(血管輪など) 胃食道逆流症閉塞性細気管支炎心不全声帯機能異常
幼児以降 2歳以降	食道胃物食物アレルギーによるアナフィラキシークループ腫瘤による気道圧迫(縦隔腫瘍など)	喘息慢性肺疾患（新生児期の呼吸器障害後) 気管支拡張症胃食道逆流症閉塞性細気管支炎先天性免疫不全症(反復性呼吸器感染) 声帯機能異常