Tie Siew Teck, Wong J L, Beniyamin A, Ho A, Kannan S K K, Jamalul Azizi A R
Department of Respiratory Medicine, Queen Elizabeth Hospital, Kota Kinabalu, Sabah, Malaysia.
Med J Malaysia. 2012 Apr;67(2):204-6.
Patients with asthma-like symptoms pose a diagnostic dilemma when physical examination is normal. The usual practice in Malaysia would be to give empirical asthma treatment. Bronchial challenge test (BCT) is widely used in many countries to diagnose asthma objectively but it is not widely available in Malaysia.
To describe our experience with BCT using methacholine at Queen Elizabeth Hospital as a supporting tool in the investigation of patients with asthma-like symptoms.
Review of case notes of patients who underwent BCT from July 2008 till April 2009. BCT was performed via dosimeter technique. Results were classified as high hyper responsiveness if the provocative dose of methacholine required to achieve 20% fall in FEV1 (PD20) was less than or equal to 0.125 micromol, moderate hyper responsiveness if PD20 was between 0.125 to 1.99 micromol or mild hyper responsiveness if PD20 was between 2.00 to 6.6 micromol. PD20 of more than 6.6 micromol constitutes a negative MCT.
29 patients had BCT during the study period. 19 cases were included in this review. The age ranged from 13 to 70 years old. There were 12 males and 7 females. Duration of symptoms ranged from 2 weeks to 23 years. BCT was positive (mild or moderate hyper responsiveness) in 10 out of 19 patients. No patient had high bronchial hyper responsiveness.
BCT is a useful adjunctive tool in the investigation of patients presenting with asthma-like symptoms. This test obviates empirical asthma treatment. BCT should be made available in all major hospitals in Malaysia.
有哮喘样症状的患者在体格检查正常时会带来诊断难题。在马来西亚，通常的做法是给予经验性哮喘治疗。支气管激发试验（BCT）在许多国家被广泛用于客观诊断哮喘，但在马来西亚却未广泛应用。
描述我们在伊丽莎白女王医院使用乙酰甲胆碱进行支气管激发试验作为辅助工具来调查有哮喘样症状患者的经验。
回顾2008年7月至2009年4月期间接受支气管激发试验患者的病历。支气管激发试验通过剂量计技术进行。如果使第一秒用力呼气容积（FEV1）下降20%所需的乙酰甲胆碱激发剂量（PD20）小于或等于0.125微摩尔，则结果分类为高反应性；如果PD20在0.125至1.99微摩尔之间，则为中度反应性；如果PD20在2.00至6.6微摩尔之间，则为轻度反应性。PD20大于6.6微摩尔构成支气管激发试验阴性。
在研究期间有29例患者进行了支气管激发试验。本综述纳入了19例。年龄范围为13至70岁。男性12例，女性7例。症状持续时间从2周至23年不等。19例患者中有10例支气管激发试验呈阳性（轻度或中度反应性）。没有患者有高支气管反应性。
支气管激发试验是调查有哮喘样症状患者的有用辅助工具。该试验避免了经验性哮喘治疗。支气管激发试验应在马来西亚所有主要医院开展。
