Otani Kenichiro, Kanazawa Hiroshi, Fujiwara Hiroshi, Hirata Kazuto, Fujimoto Shigeo, Yoshikawa Junichi
Department of Respiratory Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan.
J Asthma. 2004;41(3):271-8. doi: 10.1081/jas-120026083.
In examining the mechanisms of exercise-induced bronchoconstriction (EIB), it is important to determine which factors most strongly affect the severity of EIB. We determined such factors in patients with asthma by stepwise multiple-regression analysis.
Twenty-three patients with asthma underwent pulmonary function tests, methacholine provocation test, and sputum induction. Eosinophilic inflammatory indices and airway vascular permeability index (ratio of albumin concentrations in induced sputum and serum) were examined in sputum samples, and then an exercise test was performed by all asthmatics.
There was a significant correlation between the severity of EIB and degree of eosinophilic inflammation in induced sputum. Moreover, there was a significant correlation between the severity of EIB and airway vascular permeability index. Although we could not find a significant correlation between the severity of EIB and 1-sec forced expired volume, 20% provocation concentration of (PC20) methacholine tended to be correlated with the severity of EIB. By stepwise multiple-regression analysis, we also found that airway vascular permeability index, eosinophil cationic protein levels in sputum, and PC20 methacholine are independent predictors of the severity of EIB.
We found that airway vascular hyperpermeability, eosinophilic inflammation, and bronchial hyperreactivity are independent factors predicting the severity of EIB.
在研究运动诱发性支气管收缩（EIB）的机制时，确定哪些因素对EIB的严重程度影响最大很重要。我们通过逐步多元回归分析确定了哮喘患者中的此类因素。
23例哮喘患者接受了肺功能测试、乙酰甲胆碱激发试验和痰液诱导。检测痰液样本中的嗜酸性粒细胞炎症指标和气道血管通透性指数（诱导痰与血清中白蛋白浓度之比），然后所有哮喘患者进行运动试验。
EIB的严重程度与诱导痰中嗜酸性粒细胞炎症程度之间存在显著相关性。此外，EIB的严重程度与气道血管通透性指数之间存在显著相关性。虽然我们未发现EIB的严重程度与1秒用力呼气容积之间存在显著相关性，但乙酰甲胆碱的20%激发浓度（PC20）倾向于与EIB的严重程度相关。通过逐步多元回归分析，我们还发现气道血管通透性指数、痰液中嗜酸性粒细胞阳离子蛋白水平和乙酰甲胆碱PC20是EIB严重程度的独立预测因素。
我们发现气道血管高通透性、嗜酸性粒细胞炎症和支气管高反应性是预测EIB严重程度的独立因素。
