Zapletal Alois, Hladíková Marie, Chalupová Jana, Svobodová Tamara, Vávrová Véra
Department of Pediatrics, University Hospital Motol, Prague, Czech Republic.
Respiration. 2008;75(1):40-7. doi: 10.1159/000099615. Epub 2007 Feb 13.
The most frequently used parameters for assessing bronchoconstriction and bronchodilation are forced expiratory volume in 1 s (FEV(1)) and peak expiratory flow (PEF).
To assess the sensitivity of other parameters after induced bronchoconstriction and bronchodilation.
From maximum expiratory flow-volume (MEFV) curves, forced vital capacity, FEV(1), PEF, maximum expiratory flows (MEF) at 25, 50 and 75% of vital capacity and the area under the MEFV curve (A(ex)) were measured in two groups of asthmatic children after induced bronchoconstriction and bronchodilation, and in children with cystic fibrosis (CF) after bronchodilation.
In 142 asthmatics without airway obstruction, bronchoconstriction was induced by inhalation of 1% histamine aerosol. The 20% fall in A(ex) compared to baseline was found in all asthmatics, while the 20 and 15% falls in FEV(1) were noted in 36 and 65% of the patients, respectively. Other parameters were less sensitive or interpretation was problematic. Another 110 asthmatics with mild-moderate airway obstruction were treated with various bronchodilators. The 20% increase in A(ex) was observed in all asthmatics, while the 20% increase in FEV(1) was found in only 33% of the patients and the 15% increase in FEV(1) in 51%. In 9 CF children, the pattern of changes in A(ex) and FEV(1) after bronchodilation was similar to that in asthmatics.
A(ex) was a sensitive and less problematic parameter in the evaluation of airway patency in comparison with FEV(1) and other parameters measured from the MEFV curve in our study patients.
评估支气管收缩和舒张最常用的参数是1秒用力呼气容积（FEV₁）和呼气峰值流速（PEF）。
评估诱导支气管收缩和舒张后其他参数的敏感性。
在两组哮喘儿童诱导支气管收缩和舒张后，以及囊性纤维化（CF）儿童舒张后，从最大呼气流量-容积（MEFV）曲线测量用力肺活量、FEV₁、PEF、肺活量25%、50%和75%时的最大呼气流量（MEF）以及MEFV曲线下面积（A(ex)）。
在142名无气道阻塞的哮喘患者中，通过吸入1%组胺气雾剂诱导支气管收缩。所有哮喘患者A(ex)均较基线下降20%，而分别有36%和65%的患者FEV₁下降20%和15%。其他参数敏感性较低或解读存在问题。另外110名轻-中度气道阻塞的哮喘患者接受了各种支气管舒张剂治疗。所有哮喘患者A(ex)均增加20%，而仅33%的患者FEV₁增加20%，51%的患者FEV₁增加15%。在9名CF儿童中，舒张后A(ex)和FEV₁的变化模式与哮喘患者相似。
在我们的研究患者中，与FEV₁和从MEFV曲线测量的其他参数相比，A(ex)是评估气道通畅性的一个敏感且问题较少的参数。
