Rundell K W, Wilber R L, Szmedra L, Jenkinson D M, Mayers L B, Im J
Sport Science and Technology Division, United States Olympic Committee, Lake Placid, NY 12946, USA.
Med Sci Sports Exerc. 2000 Feb;32(2):309-16. doi: 10.1097/00005768-200002000-00010.
The purpose of this study was to compare a laboratory based exercise challenge (LBC) to a field based exercise challenge (FBC) for pulmonary function test (PFT) exercise-induced asthma (EIA) screening of elite athletes.
Twenty-three elite cold weather athletes (14 men, 9 women) PFT positive for EIA (FBC screened) served as subjects. Twenty-three gender and sport matched controls (nonasthmatics) were randomly selected to establish PFT reference values for normal elite athletes. Before FBC, athletes completed a medical history questionnaire for EIA symptoms. FBC evaluations consisted of baseline spirometry, actual or simulated competition, and 5, 10, and 15 min postexercise spirometry. PFT positive athletes were evaluated in the laboratory using an exercise challenge simulating race intensity (ambient conditions: 21 degrees C, 60% relative humidity). PFT procedures were identical to FBC.
91% of PFT positive and 48% of PFT normal athletes reported at least one symptom of EIA, with postrace cough most frequent. Baseline spirometry was the same for PFT positives and normal controls. Lower limit reference range (MN - 2 SD) of FEV1 for controls suggests that postexercise decrements of greater than approximately -7% indicate abnormal airway response in this population. Exercise time duration did not effect bronchial reactivity; 78% of FBC PFT positives were PFT normal post-LBC.
Self-reported symptoms by elite athletes are not reliable in identifying EIA. Reference range criterion for FEV1 decrement in the elite athlete postexercise contrasts current recommended guidelines. Moreover, a large number of false negatives may occur in this population if EIA screening is performed with inadequate exercise and environmental stress.
本研究的目的是比较基于实验室的运动挑战（LBC）和基于现场的运动挑战（FBC）在精英运动员肺功能测试（PFT）运动诱发哮喘（EIA）筛查中的效果。
23名EIA筛查（FBC筛查）PFT呈阳性的精英寒季运动员（14名男性，9名女性）作为研究对象。随机选取23名性别和运动项目匹配的对照组（非哮喘患者），以确定正常精英运动员的PFT参考值。在进行FBC之前，运动员完成了一份关于EIA症状的病史问卷。FBC评估包括基线肺量计测量、实际或模拟比赛以及运动后5、10和15分钟的肺量计测量。PFT呈阳性的运动员在实验室中使用模拟比赛强度的运动挑战进行评估（环境条件：21摄氏度，相对湿度60%）。PFT程序与FBC相同。
91%的PFT阳性运动员和48%的PFT正常运动员报告至少有一种EIA症状，赛后咳嗽最为常见。PFT阳性者和正常对照组的基线肺量计测量结果相同。对照组FEV1的下限参考范围（MN - 2 SD）表明，运动后下降幅度大于约-7%表明该人群气道反应异常。运动持续时间不影响支气管反应性；78%的FBC PFT阳性者在LBC后PFT正常。
精英运动员自我报告的症状在识别EIA方面不可靠。精英运动员运动后FEV1下降的参考范围标准与当前推荐指南不同。此外，如果在运动和环境压力不足的情况下进行EIA筛查，该人群中可能会出现大量假阴性结果。
