Renwick D S, Connolly M J
University Department of Medicine for the Elderly, Barnes Hospital, Manchester, UK.
Chest. 1999 Mar;115(3):660-5. doi: 10.1378/chest.115.3.660.
Increased bronchial responsiveness is a feature of symptomatic asthma, and it predicts the onset of wheezing. We have investigated the relationship between bronchial responsiveness and age in a population sample with an age range of 45 to 86 years.
Cross-sectional population survey.
Population of Central Manchester, UK.
An age-stratified random sample of white adults aged > or = 45 years old and living in Central Manchester. They were recruited from their primary care physician (general practitioner) lists. Patients with confusion and patients who were housebound were excluded.
Respondents to a mail questionnaire were invited to attend a methacholine bronchial challenge performed using the Newcastle dosimeter method. Respondents with ischemic heart disease or respondents taking oral steroids, beta-blockers, or anticholinergic medication were excluded.
Of the 783 subjects contacted, 92.3% of the subjects responded, and 508 subjects returned enough information for us to deduce their suitability for the bronchial challenge. Of the 395 suitable subjects, 247 subjects participated (62.5% of those invited; 31.5% of the study population), and 208 participants completed the bronchial challenge. Participants were slightly younger than nonparticipants, but they were otherwise representative of the population. Increased bronchial responsiveness (provocative dose of methacholine causing a 20% fall in FEV1 < or = 200 microg) was present in 71 (34.1%) participants. Stepwise multiple regression analysis showed weak, independent, positive associations between bronchial responsiveness and age, and between bronchial responsiveness and the total immunoglobulin E level. There was an independent negative relationship between bronchial responsiveness and the airways caliber (expressed as standardized residuals; R2 = 0.29).
We have found a high prevalence of increased bronchial responsiveness in this inner-city population of older adults. Bronchial responsiveness showed a weak independent positive association with age.
支气管反应性增加是症状性哮喘的一个特征，且可预测喘息的发作。我们在一个年龄范围为45至86岁的人群样本中研究了支气管反应性与年龄之间的关系。
横断面人群调查。
英国曼彻斯特市中心人群。
年龄分层的随机样本，为居住在曼彻斯特市中心、年龄≥45岁的白人成年人。他们从其初级保健医生（全科医生）名单中招募。排除意识不清的患者和居家不能外出的患者。
对邮寄问卷的回复者邀请其参加使用纽卡斯尔剂量计法进行的乙酰甲胆碱支气管激发试验。排除患有缺血性心脏病的回复者以及正在服用口服类固醇、β受体阻滞剂或抗胆碱能药物的回复者。
在联系的783名受试者中，92.3%的受试者进行了回复，508名受试者返回了足够的信息，使我们能够推断他们是否适合进行支气管激发试验。在395名合适的受试者中，247名受试者参与（占受邀者的62.5%；占研究人群的31.5%），208名参与者完成了支气管激发试验。参与者比未参与者略年轻，但在其他方面代表了该人群。71名（34.1%）参与者存在支气管反应性增加（引起FEV1下降20%的乙酰甲胆碱激发剂量≤200微克）。逐步多元回归分析显示支气管反应性与年龄之间以及支气管反应性与总免疫球蛋白E水平之间存在微弱、独立的正相关。支气管反应性与气道口径之间存在独立的负相关（以标准化残差表示；R2 = 0.29）。
我们发现在这个市中心老年人群中支气管反应性增加的患病率很高。支气管反应性与年龄之间存在微弱的独立正相关。
