Caire N, Cartier A, Ghezzo H, Malo J L
Dept of Chest Medicine, Hôpital du Sacré-Coeur, Montreal, Canada.
Eur Respir J. 1989 Sep;2(8):741-5.
Hyperventilation of cold dry air causes bronchoconstriction in asthmatic subjects and has been proposed as a test for assessing bronchial hyperresponsiveness. The influence of the duration of inhalation of unconditioned cold air has not been studied. We have investigated the question in 12 asthmatic subjects in a clinically stable state. Each subject underwent three inhalation tests at a maximum interval of two weeks. On each day, the duration of inhalation was different, being randomly 2, 3 or 4 min depending on the subject. Doubling doses of cold air produced by a freon conditioner were administered, increasing ventilation from 7.5 to 15, 30, 60 l.min-1 and maximum voluntary ventilation (MVV). Forced expiratory volume in one second (FEV1) was assessed after each period of cold air inhalation. The test was stopped when the FEV1 had decreased by 20% or more, or when MVV had been achieved. The dose of cold air expressed as the level of ventilation causing a 20% change in FEV1 (PD20) was interpolated from individual dose-response curves. Dose-response curves shifted to the left when the duration of ventilation was increased. PD20 was significantly lower after 3 min of ventilation than after 2 min (mean +/- SD PD20 of 41.7 +/- 1.4 l.min-1 compared with 53.3 +/- 1.2 l.min-1; p = 0.002). There was a further fall in PD20 after 4 min of ventilation (PD20 = 36.1 +/- 1.5 l.min-1) but the difference compared with the values obtained after 3 min was not significant (p = 0.09), thus suggesting a plateau.(ABSTRACT TRUNCATED AT 250 WORDS)
吸入冷干空气导致哮喘患者支气管收缩,这已被提议作为评估支气管高反应性的一项测试。吸入未调节的冷空气的持续时间的影响尚未得到研究。我们在12名临床状态稳定的哮喘患者中研究了这个问题。每个受试者在最长两周的间隔内进行了三次吸入测试。每天,吸入持续时间不同,根据受试者随机为2、3或4分钟。使用氟利昂空调产生的冷空气剂量加倍,使通气量从7.5增加到15、30、60升·分钟⁻¹以及最大自主通气量(MVV)。在每次吸入冷空气后评估一秒用力呼气量(FEV1)。当FEV1下降20%或更多,或达到MVV时,测试停止。将导致FEV1变化20%的通气水平表示的冷空气剂量(PD20)从个体剂量 - 反应曲线中插值得到。当通气持续时间增加时,剂量 - 反应曲线向左移动。通气3分钟后的PD20显著低于2分钟后(平均±标准差:41.7±1.4升·分钟⁻¹与53.3±1.2升·分钟⁻¹相比;p = 0.002)。通气4分钟后PD20进一步下降(PD20 = 36.1±1.5升·分钟⁻¹),但与3分钟后获得的值相比差异不显著(p = 0.09),因此表明存在一个平台期。(摘要截断于250字)