Wilson N M, Chudry N, Silverman M
Department of Paediatrics and Neonatal Medicine, Royal Postgraduate Medical School, London.
Thorax. 1987 Jul;42(7):506-10. doi: 10.1136/thx.42.7.506.
Twelve Asian patients with a history of asthma exacerbated by ingestion of ice and acidic drinks were selected for study. To determine the site of response to ingested ice and acid they were challenged with ice or dilute hydrochloric acid, which was orally retained on one day and swallowed on another. On a third day a placebo was given. The airway response was assessed by measuring FEV1 and the provocative concentration of histamine that reduced the FEV1 by at least 20% (PC20). There was no significant change in FEV1 or histamine PC20 after placebo or the orally retained challenges for the group as a whole or for any individual. After the ice and hydrochloric acid had been swallowed there was a small but statistically significant mean fall in FEV1, increasing to a maximum 90 minutes after ingestion, together with a significant increase in bronchial responsiveness. As conditioning of the inspired air would have been similar after orally retained and after swallowed ice or acid, the response is likely to be due to oesophageal stimulation. The mechanism of the response to oesophageal stimulation is unclear, but the slow time course seems to preclude a simple neural reflex.
选取了12名有因摄入冰块和酸性饮料而诱发哮喘病史的亚洲患者进行研究。为了确定对摄入冰块和酸的反应部位，让他们接受冰块或稀盐酸激发试验，在一天内将其含于口中，在另一天咽下。第三天给予安慰剂。通过测量第一秒用力呼气量（FEV1）以及使FEV1至少降低20%的组胺激发浓度（PC20）来评估气道反应。对于整个组或任何个体，给予安慰剂后或口中含服激发物后，FEV1或组胺PC20均无显著变化。在咽下冰块和盐酸后，FEV1出现了小幅度但具有统计学意义的平均下降，在摄入后90分钟时降至最大，同时支气管反应性显著增加。由于在口中含服以及咽下冰块或酸后对吸入空气的调节可能相似，所以这种反应可能是由于食管刺激所致。对食管刺激的反应机制尚不清楚，但反应的缓慢时间进程似乎排除了简单的神经反射。
