Prendiville A, Green S, Silverman M
Department of Paediatrics and Neonatal Medicine, Royal Postgraduate Medical School, Hammersmith Hospital, London.
Thorax. 1987 Feb;42(2):92-9. doi: 10.1136/thx.42.2.92.
Little is known about airway responsiveness in infancy. The bronchial response to incremental doses of nebulised histamine (to a maximum dose of 8 g/l) was measured in 11 wheezy infants with a mean age of 8.7 months. The study was repeated after a 30-40 minute recovery period in seven infants and again on a separate day in 10. The index of response was the provoking concentration of histamine that produced a 30% fall in the maximum expiratory flow at functional residual capacity (PC30), taken from partial forced expiratory flow-volume curves produced in a pressure jacket. Nine of 11 infants had a PC30 of less than 8 g/l. The response was consistent between tests in both the nine responders and the two who failed to respond at 8 g/l. The PC30 was lower in infants with more severe baseline airway obstruction. Spontaneous recovery after challenge was complete in 30 minutes in seven of eight infants studied. The highest doses of histamine caused changes in the configuration of the flow-volume curves and symptomatic cough and wheeze in addition to a change in forced flow rates. This study provides clear evidence of intrathoracic airway responsiveness to histamine in infancy.
关于婴儿期气道反应性，人们了解甚少。对11名平均年龄为8.7个月的喘息婴儿，测量了其对递增剂量雾化组胺（最大剂量为8μg/l）的支气管反应。7名婴儿在30 - 40分钟恢复期后重复该研究，10名婴儿在另一天再次进行研究。反应指标是组胺激发浓度，即产生功能残气量时最大呼气流量下降30%的组胺浓度（PC30），该指标取自压力衣中产生的部分用力呼气流量 - 容积曲线。11名婴儿中有9名的PC30小于8μg/l。在9名有反应者和2名在8μg/l时无反应者中，两次测试的反应均一致。基线气道阻塞更严重的婴儿，其PC30更低。在研究的8名婴儿中，7名在激发后30分钟内完全自发恢复。最高剂量的组胺除了导致用力流速改变外，还引起流量 - 容积曲线形态改变以及有症状的咳嗽和喘息。这项研究提供了婴儿期胸内气道对组胺有反应性的明确证据。
