Poussel M, Chenuel B
Service des explorations fonctionnelles respiratoires et de l'aptitude à l'exercice, CHU de Nancy-Brabois Adultes, rue du Morvan, 54511 Vandœuvre-lès-Nancy, France.
Rev Mal Respir. 2010 Oct;27(8):898-906. doi: 10.1016/j.rmr.2010.08.004. Epub 2010 Sep 28.
A new clinical entity, exercise-induced bronchoconstriction (EIB), has been recently defined which describes bronchoconstriction occurring in association with exercise in susceptible non-asthmatic persons.
There is considerable evidence that the pathogenesis of this condition is related to airway injury, due to prolonged hyperventilation and aggressive environmental factors. If the objective diagnostic tests are identical for the diagnosis of exercise induced asthma and EIB, the diagnoses are established differently, according to the high sensitivity of provocation by exercise "in the field" or the eucapnic voluntary hyperventilation provocation test.
Current pharmacological treatment is based upon the inhalation of ß2-agonists prior to exercise, but to be granted permission to use them, athletes are required to provide documentation of objective evidence of EIB. Therefore, the diagnostic pathway in athletes is essential and respiratory physicians need to know the specific features of this new clinical entity.
EIB distinct from the presence of asthma is prevalent in elite athletes and its determinants should be well known by their health care providers to assure an optimal management of this peculiar disease, in respect to drug doping regulations.
最近定义了一种新的临床病症——运动诱发性支气管收缩(EIB),它描述了在易患的非哮喘患者中与运动相关的支气管收缩。
有大量证据表明,由于长时间过度通气和恶劣的环境因素,这种病症的发病机制与气道损伤有关。如果运动诱发性哮喘和EIB的客观诊断测试相同,那么诊断方式则有所不同,这取决于运动“现场”激发试验的高敏感性或等二氧化碳通气过度激发试验。
目前的药物治疗基于运动前吸入β2激动剂,但运动员若要获准使用这些药物,需要提供EIB客观证据的文件。因此,运动员的诊断途径至关重要,呼吸内科医生需要了解这一新临床病症的具体特征。
与哮喘不同,EIB在精英运动员中很普遍,其决定因素应由他们的医疗保健提供者熟知,以便在药物兴奋剂规定方面确保对这种特殊疾病进行最佳管理。