剧烈运动可导致健康青少年肺功能异常。
Vigorous Exercise Can Cause Abnormal Pulmonary Function in Healthy Adolescents.
作者信息
Abosaida Alladdin, Chen Jen Jen, Nussbaum Eliezer, Leu Szu-Yun, Chin Terry, Schwindt Christina D
机构信息
1 Department of Pediatrics, School of Medicine, University of California, Irvine (UC Irvine), Irvine, California.
2 Miller Children's Hospital, Long Beach, California; and.
出版信息
Ann Am Thorac Soc. 2015 Jun;12(6):872-7. doi: 10.1513/AnnalsATS.201411-520OC.
RATIONALE
Although exercise-induced bronchoconstriction is more common in adolescents with asthma, it also manifests in healthy individuals without asthma. The steady-state exercise protocol is widely used and recommended by the American Thoracic Society (ATS) as a method to diagnose exercise-induced bronchoconstriction. Airway narrowing in response to exercise is thought to be related to airway wall dehydration secondary to hyperventilation. More rigorous exercise protocols may have a role in detecting exercise-induced bronchoconstriction in those who otherwise have a normal response to steady-state exercise challenge.
OBJECTIVES
The objective of this study was to determine the effect of two different exercise protocols--a constant work rate protocol and a progressive ramp protocol--on pulmonary function testing in healthy adolescents. We hypothesized that vigorous exercise protocols would lead to reductions in lung function in healthy adolescents.
METHODS
A total of 56 healthy adolescents (mean age, 15.2 ± 3.3 [SD] years) were recruited to perform two exercise protocols: constant work rate exercise test to evaluate for exercise-induced bronchoconstriction (as defined by ATS) and standardized progressive ramp protocol. Pulmonary function abnormalities were defined as a decline from baseline in FEV1 of greater than 10%.
MEASUREMENTS AND MAIN RESULTS
Ten participants (17.8%) had a significant drop in FEV1. Among those with abnormal lung function after exercise, three (30%) were after the ATS test only, five (50%) were after the ramp test only, and two (20%) were after both ATS and ramp tests.
CONCLUSION
Healthy adolescents demonstrate subtle bronchoconstriction after exercise. This exercise-induced bronchoconstriction may be detected in healthy adolescents via constant work rate or the progressive ramp protocol. In a clinical setting, ramp testing warrants consideration in adolescents suspected of having exercise-induced bronchoconstriction and who have normal responses to steady-state exercise testing.
原理
尽管运动诱发的支气管收缩在哮喘青少年中更为常见，但在无哮喘的健康个体中也有表现。稳态运动方案被美国胸科学会（ATS）广泛使用并推荐为诊断运动诱发支气管收缩的一种方法。运动引起的气道狭窄被认为与过度通气继发的气道壁脱水有关。更严格的运动方案可能有助于检测那些对稳态运动挑战反应正常的人是否存在运动诱发的支气管收缩。
目的
本研究的目的是确定两种不同的运动方案——恒定工作率方案和渐进斜坡方案——对健康青少年肺功能测试的影响。我们假设剧烈运动方案会导致健康青少年肺功能下降。
方法
共招募了56名健康青少年（平均年龄15.2±3.3[标准差]岁），让他们执行两种运动方案：评估运动诱发支气管收缩的恒定工作率运动测试（如ATS所定义）和标准化渐进斜坡方案。肺功能异常定义为第一秒用力呼气容积（FEV1）较基线下降超过10%。
测量与主要结果
10名参与者（17.8%）的FEV1有显著下降。在运动后肺功能异常的参与者中，3名（30%）仅在ATS测试后出现异常，5名（50%）仅在斜坡测试后出现异常，2名（20%）在ATS和斜坡测试后均出现异常。
结论
健康青少年运动后会出现轻微的支气管收缩。通过恒定工作率或渐进斜坡方案，可能在健康青少年中检测到这种运动诱发的支气管收缩。在临床环境中，对于怀疑有运动诱发支气管收缩且对稳态运动测试反应正常的青少年，斜坡测试值得考虑。
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