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实验性鼻病毒感染期间呼气峰值流速的变化。

Peak expiratory flow changes during experimental rhinovirus infection.

作者信息

Bardin P G, Fraenkel D J, Sanderson G, van Schalkwyk E M, Holgate S T, Johnston S L

机构信息

University Medicine, Southampton General Hospital, UK.

出版信息

Eur Respir J. 2000 Nov;16(5):980-5. doi: 10.1183/09031936.00.16598000.

Abstract

Rhinovirus (RV) colds are associated with asthma exacerbations and experimental infections are commonly used to investigate the mechanisms involved. However, a temporal association between experimental RV infections and falls in peak expiratory flow (PEF) have not been demonstrated. PEF was measured in 22 volunteers (11 normal, five atopic, six atopic asthmatic) who developed RV serotype 16 colds after inoculation. PEF was measured twice daily for 2 weeks prior and 6 weeks after RV infection and episodes of respiratory morbidity based on changes in PEF were defined using validated criteria. Six significant reductions in PEF were temporally related to the RV infections (in two (18%) normal, one (20%) atopic, three (50%) atopic asthmatic subjects, p=0.1) and occurred 4-9 days (median 6) after inoculation. Mean+/-SEM PEF at day 6 was 87.8+/-1.8% of the predicted value in the six subjects with reductions versus 99.4+/-1.4% pred in those without (p=0.01). Symptom scores were significantly different at day 6 in the two groups (10.6+/-1.9 versus 6.8+/-1.0, p=0.03), but no differences were noted in the viral culture scores and changes in nasal albumin. In subjects with significant PEF reduction, the decrease in the provocative concentration causing a 20% fall in the forced expiratory volume in one second (FEV1) (PC20) was 1.7+/-1.3 mg x mL(-1) versus 1.2+/-1.1 mg x mL(-1) in the negative group (p=0.06). The degree of seroconversion to RV was significantly higher in the group with reduced PEF (median change dilutions 8 versus 4, p=0.02). The results of the present study suggest that rhinovirus-associated, respiratory morbidity occurs during experimental infection in some but not all normal and asthmatic subjects and also that experimental colds are a valid model for the study of rhinovirus-associated airway symptoms and asthma exacerbations.

摘要

鼻病毒(RV)感冒与哮喘加重有关,实验性感染常用于研究其中涉及的机制。然而,实验性RV感染与呼气峰值流速(PEF)下降之间的时间关联尚未得到证实。对22名志愿者(11名正常人、5名特应性个体、6名特应性哮喘患者)进行了PEF测量,这些志愿者在接种后患上了RV16型感冒。在RV感染前2周和感染后6周,每天测量两次PEF,并根据PEF变化,使用经过验证的标准定义呼吸道发病情况。有6次PEF显著下降与RV感染在时间上相关(2名(18%)正常人、1名(20%)特应性个体、3名(50%)特应性哮喘患者,p=0.1),且发生在接种后4 - 9天(中位数为6天)。在PEF下降的6名受试者中,第6天的平均±标准误PEF为预测值的87.8±1.8%,而未下降的受试者为99.4±1.4%预测值(p=0.01)。两组在第6天的症状评分有显著差异(10.6±1.9对6.8±1.0,p=0.03),但病毒培养评分和鼻白蛋白变化无差异。在PEF显著下降的受试者中,使一秒用力呼气量(FEV1)下降20%的激发浓度(PC20)降低了1.7±1.3mg·mL⁻¹,而阴性组为1.2±1.1mg·mL⁻¹(p=0.06)。PEF降低组中RV血清转化程度显著更高(中位数变化稀释倍数8对4,p=0.02)。本研究结果表明,在一些但并非所有正常和哮喘受试者的实验性感染期间会发生鼻病毒相关的呼吸道发病,并且实验性感冒是研究鼻病毒相关气道症状和哮喘加重的有效模型。

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