Spiropoulos K, Stevens J, Eigen H, Spiropoulos A
Acta Paediatr Scand. 1986 Sep;75(5):737-43. doi: 10.1111/j.1651-2227.1986.tb10283.x.
To assess the ability of the methacholine challenge test for separation between normals and patients with clinically apparent mild airway hyperreactivity, the provocative dose of inhaled methacholine required to cause a 20% drop in the forced expiratory volume in one second was evaluated in two selected pediatric populations. On the basis of a standardized respiratory questionnaire, 70 subjects, 4-16 years of age were identified. Included were 49 normal individuals, and 21 individuals with mild airway hyperreactivity who responded to bronchodilators. Methacholine inhalation challenges were performed by use of a standard inhalation procedure. Forty-seven percent of the normals (23/49) had a positive methacholine challenge test while 24% (5/21) of the patients with hyperreactive airways had a negative test by the standard criteria. A wide spectrum of specificity and sensitivity of methacholine challenge was obtained at different doses of methacholine. The greater the sensitivity, the lower the specificity. Therefore, we postulate that the methacholine challenge test can be helpful in making the clinical diagnosis but it does not allow a clear and perfect separation between normal and clinically apparent mildly airway reactive patients in a pediatric age population.
为评估乙酰甲胆碱激发试验区分正常人与临床症状明显的轻度气道高反应性患者的能力，我们在两个选定的儿科人群中评估了使一秒用力呼气量下降20%所需的吸入乙酰甲胆碱激发剂量。根据一份标准化的呼吸问卷，确定了70名4至16岁的受试者。其中包括49名正常个体和21名对支气管扩张剂有反应的轻度气道高反应性个体。使用标准吸入程序进行乙酰甲胆碱吸入激发试验。47%（23/49）的正常个体乙酰甲胆碱激发试验呈阳性，而根据标准标准，24%（5/21）的气道高反应性患者试验呈阴性。在不同剂量的乙酰甲胆碱下，乙酰甲胆碱激发试验具有广泛的特异性和敏感性。敏感性越高，特异性越低。因此，我们推测乙酰甲胆碱激发试验有助于临床诊断，但在儿科人群中，它无法在正常人与临床症状明显的轻度气道反应性患者之间进行清晰、完美的区分。
