Baur X
Ordinariat für Arbeitsmedizin, Universitätsklinikum Hamburg-Eppendorf, Zentralinstitut für Arbeitsmedizin und Maritime Medizin Hamburg, Seewartenstrasse 10, Hamburg.
Pneumologie. 2011 Jun;65(6):340-6. doi: 10.1055/s-0030-1255967. Epub 2010 Dec 10.
This is an updated overview of indications, contraindications, performance and interpretation of bronchial challenge tests. As speciality, the diagnostic step by step scheme comprises in addition to the clinical case history a detailed exposure (occupational) history, lung function testing, assessment of nonspecific bronchial hyperresponsiveness, allergological diagnostics (skin prick test, measurement of specific IgE antibodies), privation and reexposure test and as gold standard specific bronchial challenge tests. The last mentioned tests are of particular importance in the framework of a diagnostic backup with regard to specific therapeutic and preventive measures and insurance regulations (occupational disease?). Specific bronchial challenge tests and their variant, the workplace-related challenge test, serve to objectify or exclude the clinical relevance and the current state of a respiratory sensitization. They require a comprehensive experience of the physician performing the tests. The majority of diseases does not necessitate these tests, especially if case history, lung function testing, allergy tests, privation and reexposure test provide unanimously positive results. If allergic symptoms of conjunctiva or the upper respiratory tract are of prime importance the performance of a specific conjunctival or nasal challenge test is recommended.
这是一篇关于支气管激发试验的适应证、禁忌证、操作及结果解读的最新综述。作为一项专业检查，逐步诊断方案除了包括临床病史外，还涵盖详细的暴露（职业）史、肺功能测试、非特异性支气管高反应性评估、变应性诊断（皮肤点刺试验、特异性IgE抗体检测）、激发和再激发试验，以及作为金标准的特异性支气管激发试验。在针对特定治疗和预防措施及保险规定（职业病？）的诊断支持框架内，最后提到的这些试验尤为重要。特异性支气管激发试验及其变体——与工作场所相关的激发试验，用于证实或排除呼吸道致敏的临床相关性及当前状态。它们需要实施检测的医生具备丰富经验。大多数疾病并不需要这些试验，尤其是当病史、肺功能测试、过敏试验、激发和再激发试验均得出一致阳性结果时。如果结膜或上呼吸道的过敏症状至关重要，建议进行特异性结膜或鼻激发试验。
