Division of Allergy, Asthma, and Rheumatology, Department of Pediatrics, Chang Gung Children's Hospital, Taoyuan, Taiwan.
Department of Laboratory Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan; Department of Biotechnology & Laboratory Science, Chang Gung University, Taoyuan, Taiwan; Research Center for Emerging Viral Infections, Chang Gung University, Taoyuan, Taiwan.
J Microbiol Immunol Infect. 2019 Jun;52(3):471-479. doi: 10.1016/j.jmii.2017.08.013. Epub 2017 Sep 6.
BACKGROUND/PURPOSE: The diagnosis of exercise-induced bronchoconstriction (EIB) was established by changes in lung function after exercise challenge. The prevalence of EIB and factors related to EIB were not fully described in children with asthma. The aim of this study was to investigate the prevalence and predictors of EIB in children with asthma.
A total of 149 children with physician-diagnosed asthma above 5 years of age underwent standardized treadmill exercise challenge for EIB and methacholine challenge for airway hyper-responsiveness from October 2015 to December 2016.
EIB presented in 52.5% of children with asthma. Compared with children without EIB, there were more patients with atopic dermatitis in children with EIB (p = 0.038). Allergic to Dermatohagoides pteronyssinus and Dermatophagoides farinae were also found more in children with EIB (p = 0.045 and 0.048 respectively). Maximal decrease in forced expiratory volume in 1 s (FEV) were highest in patients who were most sensitive to methacholine provocation (provocation concentration causing 20% fall in FEV1 [PC] ≤ 1 mg/mL). Patients, who were more sensitive to methacholine challenge (with lower PC levels), develop EIB with more decline in FEV after exercise challenge (p = 0.038). Among patients with EIB, airflow limitation development in patient with methacholine-induced airway hyper-responsiveness was more abrupt and severe compared with patients without airway hyper-responsiveness (p = 0.045 and 0.033 respectively).
EIB presented in 52.5% of children with asthma. The more severe methacholine-induced hyper-responsiveness, the higher prevalence of EIB as well as the severity.
背景/目的：运动性支气管收缩（EIB）的诊断是通过运动挑战后肺功能的变化来确定的。在哮喘儿童中，EIB 的患病率以及与 EIB 相关的因素尚未得到充分描述。本研究旨在调查哮喘儿童中 EIB 的患病率和预测因素。
2015 年 10 月至 2016 年 12 月，共 149 名年龄在 5 岁以上且经医生诊断患有哮喘的儿童接受了标准化的跑步机运动挑战，以检测 EIB，并进行了乙酰甲胆碱挑战以检测气道高反应性。
52.5%的哮喘儿童存在 EIB。与无 EIB 的儿童相比，EIB 儿童中有更多的特应性皮炎患者（p=0.038）。对屋尘螨和粉尘螨过敏的儿童也更多（分别为 p=0.045 和 0.048）。对乙酰甲胆碱最敏感的患者（导致 FEV1 下降 20%的激发浓度[PC]≤1mg/ml），最大呼气量（FEV1）的下降幅度最大。对乙酰甲胆碱激发试验更敏感（PC 水平更低）的患者，在运动挑战后 FEV 下降程度更大，更容易出现 EIB（p=0.038）。在 EIB 患者中，与无气道高反应性患者相比，乙酰甲胆碱诱导的气道高反应性患者气道受限的发展更为突然和严重（分别为 p=0.045 和 0.033）。
52.5%的哮喘儿童存在 EIB。乙酰甲胆碱诱导的高反应性越严重，EIB 的患病率和严重程度越高。
