Connolly M J, Kelly C, Walters E H, Hendrick D J
Department of Respiratory Medicine, Newcastle General Hospital, University of Newcastle upon Tyne.
Age Ageing. 1988 Mar;17(2):123-8. doi: 10.1093/ageing/17.2.123.
We have assessed the feasibility and value of measuring nonspecific bronchial responsiveness to methacholine in investigation of asthma in the elderly. Results from duplicated tests in 20 subjects aged 65-82 years were expressed as dose provoking a 20% decrement in 1 second forced expiratory volume (PD20.FEV1) or peak expiratory flow (PD20.PEF). Repeatability for PD20.FEV1 was satisfactory but less good than in younger subjects, 95% confidence limits being 0.39-2.57 and 0.52-1.91, respectively, x initial PD20. For PD20.PEF, confidence limits were wider (0.26-3.91 x initial PD20) but multiple PEF measurements were better tolerated than those of FEV1, which commonly caused fatigue and dizziness. PD20.FEV1 and PD20.PEF correlated closely (r = 0.95, P less than 0.0001) and both predicted bronchodilatation following a 6-week course of inhaled corticosteroid and beta agonist. This was not predicted by the response to a single dose of beta agonist. We conclude that measurement of bronchial responsiveness is feasible and clinically valuable in elderly subjects.
我们评估了在老年哮喘患者调查中测量对乙酰甲胆碱的非特异性支气管反应性的可行性和价值。对20名年龄在65 - 82岁的受试者进行重复测试的结果，以引起一秒用力呼气量（PD20.FEV1）或呼气峰值流速（PD20.PEF）下降20%的剂量来表示。PD20.FEV1的重复性令人满意，但不如年轻受试者，95%置信区间分别为初始PD20的0.39 - 2.57倍和0.52 - 1.91倍。对于PD20.PEF，置信区间更宽（初始PD20的0.26 - 3.91倍），但多次PEF测量比FEV1测量更易耐受，FEV1测量通常会导致疲劳和头晕。PD20.FEV1和PD20.PEF密切相关（r = 0.95，P < 0.0001），并且两者都能预测吸入皮质类固醇和β激动剂6周疗程后的支气管扩张。单次剂量β激动剂的反应无法预测这一点。我们得出结论，在老年受试者中测量支气管反应性是可行的且具有临床价值。
