Sears M R, Burrows B, Herbison G P, Holdaway M D, Flannery E M
Department of Medicine, McMaster UniversitY, Hamilton, Ontario, Canada.
Clin Exp Allergy. 1993 Nov;23(11):949-56. doi: 10.1111/j.1365-2222.1993.tb00280.x.
While airway hyperresponsiveness is usually associated with a diagnosis of asthma or symptoms of wheezing, some individuals with rhinitis show airway hyperresponsiveness as do some with no symptoms whatsoever. We have studied the correlations between symptoms, airway hyperresponsiveness and atopy as determined by skin-prick tests in a cohort of New Zealand children. A total of 662 members of a birth cohort were studied at age 13 years using a respiratory questionnaire, skin-prick tests to 11 common allergens, and an abbreviated validated methacholine challenge test to determine airway responsiveness. Airway hyperresponsiveness (methacholine PC20 FEV1 < or = 8 mg/ml) was strongly correlated with reported asthma and current wheezing (P<0.0001) and also with atopy, especially to house dust mite and cat (P<0.0001). As weal size for both house dust mite and cat increased, so did the proportion of children with airway hyperresponsiveness. All children with diagnosed asthma and airway hyperresponsiveness were atopic. Skin-test reactions to house dust mite and cat were strongly correlated with any degree of measurable airway responsiveness (PC20 FEV1 < or = 25 mg/ml) in children with rhinitis (P<0.00001), and remained significantly correlated even in children without current asthma, without asthma ever and without rhinitis (P<0.001). Atopy is a major determinant of airway hyperresponsiveness in children, not only in those with reported histories of asthma and wheezing, but also in the absence of any history suggesting asthma and rhinitis.
虽然气道高反应性通常与哮喘诊断或喘息症状相关，但一些鼻炎患者以及一些毫无症状的个体也表现出气道高反应性。我们在一组新西兰儿童中研究了症状、气道高反应性与通过皮肤点刺试验确定的特应性之间的相关性。在13岁时，对一个出生队列中的662名成员进行了研究，使用了呼吸问卷、针对11种常见变应原的皮肤点刺试验以及一种简化的经过验证的乙酰甲胆碱激发试验来确定气道反应性。气道高反应性（乙酰甲胆碱PC20 FEV1≤8 mg/ml）与报告的哮喘和当前喘息密切相关（P<0.0001），也与特应性密切相关，尤其是对屋尘螨和猫过敏（P<0.0001）。随着屋尘螨和猫的风团大小增加，气道高反应性儿童的比例也增加。所有诊断为哮喘且有气道高反应性的儿童都有特应性。鼻炎儿童对屋尘螨和猫的皮肤试验反应与任何程度的可测量气道反应性（PC20 FEV1≤25 mg/ml）密切相关（P<0.00001），即使在没有当前哮喘、既往无哮喘且无鼻炎的儿童中也仍有显著相关性（P<0.001）。特应性是儿童气道高反应性的主要决定因素，不仅在有哮喘和喘息病史的儿童中如此，在没有任何提示哮喘和鼻炎病史的儿童中也是如此。
