Britton J R, Burney P G, Chinn S, Papacosta A O, Tattersfield A E
Respiratory Medicine Unit, City Hospital, Nottingham, United Kingdom.
Am Rev Respir Dis. 1988 Sep;138(3):530-4. doi: 10.1164/ajrccm/138.3.530.
Airway reactivity is known to increase in relation to the severity of asthma, and, in the community, hyperreactivity has been shown to be associated with respiratory symptoms such as wheezing and shortness of breath. However, the relation between change in airway reactivity and change in the severity of respiratory symptoms and change in the use of asthma medications within subjects has not been studied. We have investigated this relationship in a community population. In September 1984 and March 1985, the provocative dose of histamine producing a 20% fall in FEV1 (PD20) was measured, and respiratory symptoms and medication use assessed by questionnaire in 78 subjects taking part in a study of seasonal changes in airway reactivity. On both occasions, PD20 was negatively correlated with current frequency of wheezing, with the amount of asthma medication in regular use, and with the current general assessment of breathing problems. In the 45 subjects who had a PD20 value of 8 mumol or less on at least one of the two occasions tested, PD20 increased between September and March by 0.46 (SEM, 0.32) doubling doses of histamine (p = 0.16). Within subjects, change in PD20 was negatively correlated with change in the frequency of wheezing in the past month (p less than 0.005) and with change in medication use (p less than 0.05). This study demonstrates that PD20 is related to the severity of respiratory symptoms and medication use, and that change in airway reactivity within subjects in a community population is associated with changes in the frequency of wheezing and in the use of asthma medication.
气道反应性会随着哮喘严重程度的增加而升高，并且在社区中，高反应性已被证明与喘息和呼吸急促等呼吸道症状相关。然而，受试者气道反应性的变化与呼吸道症状严重程度的变化以及哮喘药物使用的变化之间的关系尚未得到研究。我们在社区人群中调查了这种关系。1984年9月和1985年3月，测量了使第一秒用力呼气容积（FEV1）下降20%的组胺激发剂量（PD20），并通过问卷调查评估了参与气道反应性季节性变化研究的78名受试者的呼吸道症状和药物使用情况。在这两个时间点，PD20均与当前喘息频率、常规使用的哮喘药物量以及当前对呼吸问题的总体评估呈负相关。在两次测试中至少有一次PD20值为8 μmol或更低的45名受试者中，PD20在9月至3月期间增加了0.46（标准误，0.32）倍组胺剂量（p = 0.16）。在受试者内部，PD20的变化与过去一个月喘息频率的变化（p < 0.005）以及药物使用的变化（p < 0.05）呈负相关。这项研究表明，PD20与呼吸道症状的严重程度和药物使用有关，并且社区人群中受试者气道反应性的变化与喘息频率和哮喘药物使用的变化相关。
