Pujol J L, Varray A, Savy-Pacaud A M, Godard P, Michel F B, Préfaut C
Clinique des Maladies Respiratoires, Hôpital de l'Aiguelongue, Montpellier.
Rev Mal Respir. 1992;9(5):517-23.
The occurrence of a late reaction following exercise induced asthma is questionable and its relationship with the non specific bronchial hyperreactivity is poorly known. In this study, nine patients (age 15-21 years) underwent an exercise challenge in order to (a) determine the incidence of immediate and late phase reaction and (b) analyse the modifications of non specific bronchial hyperreactivity. Study design was a follow; day-3: determination of bronchial responsiveness to metacholine; day 0: control day with FEV1 measurements every hour for 11 hours; day 1: exercise challenge followed by a careful observation of change in FEV1; day 2: new determination of bronchial responsiveness to metacholine. An immediate exercise induced bronchial obstruction was observed in 5 patients. A late phase reaction (6th hour) with a fall of FEV1 equal to or more than 20% has been demonstrated in two patients. For the former, the change in FEV1 did not differ from the value of the control day. For the second, the FEV1 changed spontaneously during the control day so that decreases of FEV1 during control and challenge days were parallel. Thus, no late phase reaction were observed (F = 0.46; ns). There was no modification of bronchial responsiveness to metacholine (pre-exercise: 1,784 +/- 1,970 [SD]; post-exercise 1,827 +/- 2,231 micrograms [SD]). The lack of true late phase reaction when the post-exercise change in FEV1 is compared to the one of a control day and the absence of modification of non specific bronchial hyperreactivity weaken the hypothesis of an inflammatory mechanism of exercise induced asthma.
运动诱发性哮喘后迟发反应的发生情况尚存在疑问，其与非特异性支气管高反应性的关系也鲜为人知。在本研究中，9名患者（年龄15 - 21岁）接受了运动激发试验，目的是：（a）确定速发和迟发反应的发生率；（b）分析非特异性支气管高反应性的变化。研究设计为随访研究；第3天：测定对乙酰甲胆碱的支气管反应性；第0天：对照日，每小时测量1次第1秒用力呼气容积（FEV1），共测量11小时；第1天：进行运动激发试验，随后仔细观察FEV1的变化；第2天：再次测定对乙酰甲胆碱的支气管反应性。5名患者出现了运动诱发的即刻支气管阻塞。两名患者出现了迟发反应（第6小时），FEV1下降等于或超过20%。对于前者，FEV1的变化与对照日的值无差异。对于后者，FEV1在对照日期间自发变化，因此对照日和激发日期间FEV1的下降是平行的。因此，未观察到迟发反应（F = 0.46；无显著性差异）。对乙酰甲胆碱的支气管反应性无变化（运动前：1,784 ± 1,970 [标准差]；运动后：1,827 ± 2,231微克 [标准差]）。当将运动后FEV1的变化与对照日的变化进行比较时，缺乏真正的迟发反应，且非特异性支气管高反应性无变化，这削弱了运动诱发性哮喘炎症机制的假说。
