Centro Andaluz de Medicina del Deporte, 41092 Sevilla, Spain.
Br J Sports Med. 2011 Aug;45(10):809-12. doi: 10.1136/bjsm.2008.056903. Epub 2009 Dec 2.
(a) To review the methacholine tests performed in our laboratory up until 2008; (b) to compare them with previously reported data in 2006 and (c) to examine if the anti-doping rules are meeting the needs of asthmatic athletes who really need bronchodilator treatment.
Between April 2004 and September 2008, 89 high-level athletes were examined in our laboratory in order to obtain an abbreviated therapeutic use exemption for β-2 agonists. Of these, 50 men (23.31 (7.05) years) and 23 women (20.68 (5.94) years) performed a methacholine inhalation test with increasing concentrations of methacholine (0.025, 0.25, 2.5, 5, 10 and 25 mg/ml) until a fall of 20% in forced expiratory volume in 1 s (FEV(1)) was achieved.
31 candidates (42.5%) had a provocative concentration causing a 20% fall in FEV(1) (PC(20)) <2 mg/ml; 12 (16.4%) were between 2 and 4 mg/ml; 8 (11%) between 4.1 and 8 mg/ml and 22 candidates (30.1%) had a PC(20) >8 mg/ml. Seven of the 73 candidates had an obstructive pattern in the spirometry at rest, demonstrated by a FEV(1)% <70% but with a FEV(1) >70% of the reference value.
The anti-doping regulations with respect to β-2 agonists need to be reviewed, and measures should be adopted to include a fall of 70% in FEV(1)% as an obstruction criterion to indicate a bronchodilation test and to extend the criterion for a positive methacholine test to a PC(20) of 8 mg/ml.
(a) 回顾我们实验室截至 2008 年进行的乙酰甲胆碱测试；(b) 将其与 2006 年之前报告的数据进行比较；(c) 检查反兴奋剂规则是否满足确实需要支气管扩张剂治疗的哮喘运动员的需求。
2004 年 4 月至 2008 年 9 月，我们实验室对 89 名高水平运动员进行了检查，以获得β-2 激动剂的简短治疗性使用豁免。其中，50 名男性（23.31（7.05）岁）和 23 名女性（20.68（5.94）岁）进行了乙酰甲胆碱吸入测试，乙酰甲胆碱浓度逐渐增加（0.025、0.25、2.5、5、10 和 25mg/ml），直到用力呼气量在 1 秒内下降 20%（FEV1）。
31 名候选人（42.5%）的激发浓度引起 FEV1 下降 20%（PC20）<2mg/ml；12 名（16.4%）在 2 至 4mg/ml 之间；8 名（11%）在 4.1 至 8mg/ml 之间，22 名候选人（30.1%）的 PC20>8mg/ml。73 名候选人中有 7 名在休息时的肺活量测定中表现出阻塞模式，表现为 FEV1%<70%，但 FEV1>参考值的 70%。
需要对β-2 激动剂的反兴奋剂规定进行审查，并应采取措施，将 FEV1%下降 70%纳入阻塞标准，以指示支气管扩张测试，并将阳性乙酰甲胆碱测试的标准扩展到 PC20 为 8mg/ml。
