Mortagy A K, Howell J B, Waters W E
Br Med J (Clin Res Ed). 1986 Aug 30;293(6546):525-9. doi: 10.1136/bmj.293.6546.525.
Two postal questionnaire surveys were carried out among the adult population of Southampton aimed at clarifying the diagnostic criteria for asthma (study 1) and at testing the validity of symptoms so identified as diagnostic of bronchial hyper-reactivity (study 2). The questionnaires asked about respiratory symptoms and included three questions thought likely to disclose increased bronchial reactivity. Laboratory measurements on subsamples of respondents included spirometry and bronchial challenge with increasing doses of histamine till a concentration was reached provoking a fall of more than 20% (PC greater than 20) in forced expiratory volume in one second. In the first study no normal subject (that is, one who did not report shortness of breath or wheezing on the questionnaire) had a PC greater than 20 below 0.5 g/l. Of 51 subjects who reported shortness of breath or wheezing, or both, nine had a cluster of abnormalities consisting of one or more symptoms of bronchial irritability, nocturnal dyspnoea, and prolonged morning tightness together with PC greater than 20 values of 0.5 g/l or less. These symptoms in conjunction with a low PC greater than 20 were termed the bronchial irritability syndrome. In the second study bronchial challenge confirmed the close association of these symptoms with bronchial hyper-reactivity, all other subjects being less reactive to histamine. Only 27% of subjects with symptoms of the bronchial irritability syndrome had been diagnosed as asthmatic by their general practitioners. The bronchial irritability syndrome is a definable entity for epidemiological study and patient care.
在南安普敦的成年人群体中开展了两项邮政问卷调查，旨在明确哮喘的诊断标准（研究1）以及检验所确定的作为支气管高反应性诊断依据的症状的有效性（研究2）。问卷询问了呼吸道症状，并包含三个被认为可能揭示支气管反应性增加的问题。对部分受访者的实验室检测包括肺活量测定以及用递增剂量的组胺进行支气管激发试验，直至达到能使一秒用力呼气量下降超过20%（PC大于20）的浓度。在第一项研究中，没有正常受试者（即在问卷中未报告呼吸急促或喘息的人）在组胺浓度低于0.5 g/l时PC大于20。在51名报告有呼吸急促或喘息或两者皆有的受试者中，9人有一组异常情况，包括一种或多种支气管激惹症状、夜间呼吸困难和晨起长时间胸闷，同时PC大于20的值为0.5 g/l或更低。这些症状与低PC大于20相结合被称为支气管激惹综合征。在第二项研究中，支气管激发试验证实了这些症状与支气管高反应性密切相关，所有其他受试者对组胺的反应性较低。只有27%有支气管激惹综合征症状的受试者被其全科医生诊断为哮喘。支气管激惹综合征是一个可定义的实体，可用于流行病学研究和患者护理。
