Norwegian School of Sport Sciences, Oslo, Norway.
Med Sci Sports Exerc. 2011 Mar;43(3):375-81. doi: 10.1249/MSS.0b013e3181f1c0b1.
A high prevalence of bronchial hyperresponsiveness (BHR) and respiratory symptoms has been reported among competitive swimmers. From the 2002 Winter Olympics, BHR measurements or bronchodilator reversibility have been required for approved use of β2-agonists in sports. The first aim of this study was to evaluate the relationship among respiratory symptoms in young elite swimmers, eucapnic voluntary hyperpnea (EVH), and the inhaled dose of methacholine, causing a 20% decrease in forced expiratory volume in 1 s (FEV1; PD(20 methacholine)). The second aim of this study was to assess the repeatability of the EVH test.
For this study, 15 male and 9 female adolescent elite swimmers, aged 15 to 25 yr, performed one PD(20 methacholine) test and two EVH tests in a randomized order. Dry air containing 5% CO2 was inhaled for 6 min with a target ventilation of ≥85% of maximum voluntary ventilation (minimum = 65%). PD(20 methacholine) ≤2 μmol and EVH with FEV1 reduction ≥10% were considered positive. Respiratory symptoms and medication were reported in the modified AQUA2008 questionnaire.
Twenty swimmers (83%) reported respiratory symptoms, 13 (65%) of them had a positive provocation test. Fourteen (58%) had at least one positive test to either EVH or PD(20 methacholine); three had only one positive EVH test. One athlete had BHR without symptoms. The sensitivity of PD(20 methacholine) ≤2 μmol for respiratory symptoms was 50% versus 60% and 47.37% for the two EVH tests, respectively, and 75% for PD(20 methacholine) ≤4 μmol. The Bland-Altman plot of the two EVH tests showed a consistent distribution, with only one subject outside the limits of agreement.
BHR was frequently found among adolescent competitive swimmers. PD(20 methacholine) ≤2 μmol and EVH ≥ 10% compared well, but PD(20 methacholine) ≤4 μmol had the highest sensitivity for respiratory symptoms. The EVH test has high repeatability but is very expensive and uncomfortable to perform.
有研究报道，竞技游泳运动员中存在较高的支气管高反应性（BHR）和呼吸道症状。自 2002 年冬季奥运会以来，在运动中使用β2-激动剂需要进行 BHR 测量或支气管扩张剂可逆性检查。本研究的首要目的是评估年轻精英游泳运动员的呼吸道症状、呼气末正压通气（EVH）和引起用力呼气量在 1 秒内下降 20%的乙酰甲胆碱吸入剂量（FEV1；PD（20 乙酰甲胆碱））之间的关系。本研究的第二个目的是评估 EVH 试验的重复性。
本研究中，15 名男性和 9 名女性青少年精英游泳运动员，年龄 15 至 25 岁，随机顺序进行了一次 PD（20 乙酰甲胆碱）试验和两次 EVH 试验。用含有 5%CO2 的干燥空气吸入 6 分钟，目标通气量≥最大自主通气量的 85%（最小值=65%）。PD（20 乙酰甲胆碱）≤2 μmol 和 FEV1 降低≥10%的 EVH 被认为是阳性。在改良的 AQUA2008 问卷中报告呼吸道症状和药物使用情况。
20 名游泳运动员（83%）报告有呼吸道症状，13 名（65%）有阳性激发试验。14 名（58%）有至少一项 EVH 或 PD（20 乙酰甲胆碱）阳性试验；3 名只有一项 EVH 阳性试验。1 名运动员有症状但无 BHR。PD（20 乙酰甲胆碱）≤2 μmol 对呼吸道症状的敏感性分别为 50%、60%和 47.37%，PD（20 乙酰甲胆碱）≤4 μmol 的敏感性为 75%。两项 EVH 试验的 Bland-Altman 图显示一致性分布，只有 1 名受试者超出了一致性范围。
青少年竞技游泳运动员中 BHR 较为常见。PD（20 乙酰甲胆碱）≤2 μmol 和 EVH≥10% 比较一致，但 PD（20 乙酰甲胆碱）≤4 μmol 对呼吸道症状的敏感性最高。EVH 试验具有较高的重复性，但非常昂贵且不舒服。
