McNutt G M, Schlueter D P, Fink J N
Department of Medicine, Medical College of Wisconsin, Milwaukee.
J Occup Med. 1991 Jan;33(1):19-22. doi: 10.1097/00043764-199101000-00008.
The diagnosis of occupational asthma may be difficult due to the complex mechanisms inducing the disorder. Identification of the offending agent after historical documentation may be difficult without bronchial challenge. The hallmark of asthma is bronchial hyperreactivity as detected by methacholine challenge, and this test could be considered as a screening test for asthma in the workplace. Four cases are presented that document changes in methacholine airway reactivity dependent on temporal association with exposure to the workplace or the specific offending agent. This indicates a need for a careful evaluation of symptoms relative to exposure in patients suspected for workplace asthma as well as serial determinations of methacholine response to detect potential variability in the airway reactivity.
由于引发职业性哮喘的机制复杂，其诊断可能存在困难。在没有支气管激发试验的情况下，依据病史记录来确定致病因素可能会有难度。哮喘的标志是通过乙酰甲胆碱激发试验检测到的支气管高反应性，该试验可被视为工作场所哮喘的一项筛查试验。本文介绍了4例病例，这些病例证明了乙酰甲胆碱气道反应性的变化取决于与工作场所暴露或特定致病因素的时间关联。这表明，对于疑似职业性哮喘的患者，需要仔细评估其与暴露相关的症状，并连续测定乙酰甲胆碱反应，以检测气道反应性的潜在变化。
