Anderson Sandra D, Sue-Chu Malcolm, Perry Clare P, Gratziou Christina, Kippelen Pascale, McKenzie Don C, Beck Ken C, Fitch Ken D
Department of Respiratory Medicine, Royal Prince Alfred Hospital, Camperdown, NSW, Australia.
J Allergy Clin Immunol. 2006 Apr;117(4):767-73. doi: 10.1016/j.jaci.2005.12.1355. Epub 2006 Mar 3.
The International Olympic Committee Medical Commission required a medical justification for athletes to inhale a beta2-agonist before an event at the Summer Games in Athens in 2004.
We sought to establish the percentage of athletes applying to use an inhaled beta2-agonist on the basis of the results of objective tests to establish a diagnosis of asthma or exercise-induced bronchoconstriction. We also sought to compare this percentage with the percentage of athletes simply notifying the intention to use a beta2-agonist at the previous Summer Games in Sydney in 2000.
An analysis was made of tests that measured the change in FEV1 in response to a bronchodilator or in response to a provoking stimulus, such as exercise, eucapnic voluntary hyperpnea, hypertonic saline, or methacholine.
Ten thousand six hundred fifty-three athletes competed in Athens; 4.2% were approved to use a beta2-agonist, and 0.4% were rejected. This approval rate was 26% less than the notifications in 2000 in Sydney (5.7%). Compared with Sydney 2000, there was a significant reduction of submissions and approvals for athletes from the United States, New Zealand, Australia, and Canada and in triathlon and swimming sports.
The need to provide objective testing has resulted in a reduction in the number of athletes seeking approval to use an inhaled beta2-agonist. Objective evidence has provided information for the doctor that is likely to improve the health of the athlete because many athletes appeared to be undertreated at the time of testing.
We show that documentation of airway narrowing in athletes, particularly in response to exercise or surrogate stimuli for exercise, aids in the diagnosis and management of asthma by providing evidence of bronchial hyperresponsiveness that will respond to treatment with inhaled corticosteroids and is usually associated with a reduction in respiratory symptoms on exercise.
国际奥委会医学委员会要求为运动员在2004年雅典夏季奥运会赛事前吸入β2激动剂提供医学依据。
我们试图根据客观测试结果确定申请使用吸入型β2激动剂的运动员百分比，以诊断哮喘或运动诱发的支气管收缩。我们还试图将这一百分比与2000年悉尼上一届夏季奥运会上仅通知打算使用β2激动剂的运动员百分比进行比较。
对测量吸入支气管扩张剂后或对激发刺激（如运动、等碳酸血症自主过度通气、高渗盐水或乙酰甲胆碱）后FEV1变化的测试进行分析。
10653名运动员参加了雅典奥运会；4.2%的运动员被批准使用β2激动剂，0.4%的运动员被拒绝。这一批准率比2000年悉尼奥运会的通知率（5.7%）低26%。与2000年悉尼奥运会相比，来自美国、新西兰、澳大利亚和加拿大的运动员以及铁人三项和游泳项目的提交申请和获批人数显著减少。
提供客观测试的必要性导致寻求批准使用吸入型β2激动剂的运动员数量减少。客观证据为医生提供了信息，这可能会改善运动员的健康状况，因为许多运动员在测试时似乎治疗不足。
我们表明，记录运动员气道狭窄情况，尤其是对运动或运动替代刺激的反应，有助于哮喘的诊断和管理，因为它提供了支气管高反应性的证据，这种高反应性对吸入性糖皮质激素治疗有反应，并且通常与运动时呼吸症状的减轻有关。
