Davis P B, Simpson D M, Paget G L, Turi V
J Allergy Clin Immunol. 1986 Jun;77(6):871-9. doi: 10.1016/0091-6749(86)90386-6.
Young atopic subjects with asthma who had taken no medication for 30 days and had normal pulmonary function were compared to atopic and nonatopic control subjects in several measures of beta-adrenergic response. Subjects with asthma required a larger dose of infused isoproterenol (14.3 +/- 3.9 ng/kg/min) to increase pulse pressure by a target greater than 22 mm Hg than nonatopic control subjects (8.7 +/- 3.3 ng/kg/min). Asymptomatic atopic control subjects had intermediate sensitivity (12.0 +/- 6.0 ng/kg/min) (F = 3.67; p less than 0.05). At the dose of infused isoproterenol producing the target pulse pressure response, the increase in low-frequency (1 to 8 cycles per minute) heart rate variability was less in subjects with asthma (107 +/- 34% increase in normal subjects versus 9 +/- 21% increase in subjects with asthma; p less than 0.05). In addition, subjects with the least beta-adrenergic responsiveness had the most reactive airways. Airway reactivity (assessed by the provocative concentration of methacholine causing a 20% fall in FEV1) correlated with both the dose of isoproterenol required for the target pulse pressure response (Rs = -0.46; p less than 0.05) and the isoproterenol-induced increase in low-frequency heart-rate variability (Rs = 0.47; p less than 0.05). In contrast, in lymphocytes and granulocytes from these same subjects, the cAMP response to isoproterenol and beta-adrenergic receptor number were identical in normal subjects and subjects with asthma and unrelated to airway reactivity or to cardiovascular beta-adrenergic responses. Thus, different results for beta-adrenergic responsiveness in subjects with asthma are obtained in different tests in the same subjects.
将未用药30天且肺功能正常的年轻特应性哮喘患者与特应性和非特应性对照受试者进行了多项β-肾上腺素能反应指标的比较。与非特应性对照受试者（8.7±3.3 ng/kg/min）相比，哮喘患者需要更大剂量的静脉输注异丙肾上腺素（14.3±3.9 ng/kg/min）才能使脉压升高超过22 mmHg的目标值。无症状的特应性对照受试者具有中等敏感性（12.0±6.0 ng/kg/min）（F = 3.67；p<0.05）。在产生目标脉压反应的静脉输注异丙肾上腺素剂量下，哮喘患者低频（每分钟1至8次心跳周期）心率变异性的增加较少（正常受试者增加107±34%，哮喘患者增加9±21%；p<0.05）。此外，β-肾上腺素能反应性最低的受试者气道反应性最强。气道反应性（通过引起FEV1下降20%的乙酰甲胆碱激发浓度评估）与目标脉压反应所需的异丙肾上腺素剂量（Rs = -0.46；p<0.05）以及异丙肾上腺素诱导的低频心率变异性增加（Rs = 0.47；p<0.05）均相关。相比之下，在这些相同受试者的淋巴细胞和粒细胞中，正常受试者和哮喘患者对异丙肾上腺素的cAMP反应以及β-肾上腺素能受体数量相同，且与气道反应性或心血管β-肾上腺素能反应无关。因此，在同一受试者的不同测试中，哮喘患者的β-肾上腺素能反应性会得到不同结果。
