Rupp N T, Guill M F, Brudno D S
Department of Pediatrics, Medical College of Georgia, Augusta 30912.
Am J Dis Child. 1992 Aug;146(8):941-4. doi: 10.1001/archpedi.1992.02160200063028.
OBJECTIVE--As part of their preparticipation physical examinations, 1241 middle and high school student athletes completed a questionnaire and were interviewed to elicit risk factors for unrecognized exercise-induced bronchospasm (EIB). Spirometry was then performed when the students were at rest. RESEARCH DESIGN--All participants completed a questionnaire, were interviewed, and underwent baseline testing to determine forced expiratory volume in 1 second (FEV1). SETTING--All testing was performed in a school setting. SELECTION PROCEDURES--Athletes known to have EIB who were receiving appropriate treatment (46 athletes [4%]) and athletes with no risk factors based on medical history and normal results of spirometry (847 athletes [68%]) were eliminated from further evaluation. Students with medical histories indicating risk of unrecognized EIB and students with abnormal results of spirometry were eligible for exercise challenge by standard treadmill protocol. MEASUREMENTS AND RESULTS--Of the 348 eligible students, 230 (66%) completed the exercise challenge. Sixty-six of the 230 students had greater than 15% reduction in FEV1, and 50 of the 66 students had greater than 20% reduction, representing a 29% occurrence of previously undiagnosed EIB in a population of students identified with screening to be at risk of unrecognized EIB. Of the 179 students identified to be at risk based on medical history only, 28% had EIB. Of 33 students with positive results of spirometry but no medical history that put them at risk, 15% had EIB. Of the 18 students with medical histories that put them at risk and positive results of spirometry, 61% had EIB. Including the subpopulation with reduction in FEV1 of greater than 15%, students shown to be at risk after screening, and students previously identified as having EIB, 145 students were identified as having EIB (12%). CONCLUSIONS--These data are in accord with results of previously reported studies of college and Olympic athletes. The data may have implications for more extensive screening in the adolescent population.
目的——作为其参与运动前体格检查的一部分，1241名初高中学生运动员完成了一份问卷并接受访谈，以找出未被识别的运动诱发支气管痉挛（EIB）的风险因素。然后在学生休息时进行肺活量测定。研究设计——所有参与者均完成一份问卷、接受访谈并进行基线测试，以确定一秒用力呼气量（FEV1）。研究地点——所有测试均在学校环境中进行。选择程序——已知患有EIB且正在接受适当治疗的运动员（46名运动员[4%]）以及根据病史和肺活量测定结果正常而无风险因素的运动员（847名运动员[68%]）被排除在进一步评估之外。有病史表明存在未被识别的EIB风险的学生以及肺活量测定结果异常的学生有资格按照标准跑步机方案进行运动激发试验。测量与结果——在348名符合条件的学生中，230名（66%）完成了运动激发试验。230名学生中有66名FEV1降低超过15%，66名学生中有50名降低超过20%，这表明在经筛查被确定有未被识别的EIB风险的学生群体中，既往未诊断出的EIB发生率为29%。在仅根据病史被确定有风险的179名学生中，28%患有EIB。在肺活量测定结果为阳性但无使其处于风险中的病史的33名学生中，15%患有EIB。在有使其处于风险中的病史且肺活量测定结果为阳性的18名学生中，61%患有EIB。包括FEV1降低超过15%的亚组、筛查后显示有风险的学生以及先前被确定患有EIB的学生，共有145名学生被确定患有EIB（12%）。结论——这些数据与先前关于大学生和奥运会运动员的研究结果一致。这些数据可能对青少年人群进行更广泛的筛查有启示意义。
