Spinelli A, Lo Conte C, Gorini M, Duranti R, Gigliotti F, Scibilia M R, Scano G
Istituto di Clinica Medica III, Università degli Studi, Policlinico di Careggi, Firenze, Italy.
Respiration. 1987;52(2):137-43. doi: 10.1159/000195316.
Histamine inhalation provocation tests were performed in 18 asymptomatic asthmatic patients with progressively increasing doses of a pressurized aerosol of histamine phosphate. Forced expiratory volume in 1 s (FEV1), total neuromuscular output, assessed by mouth occlusion pressure (P0.1), mean inspiratory flow (VT/Ti), and the P0.1/(VT/Ti) ratio, which represents an index of effective inspiratory impedance of the respiratory system, were measured. With histamine, compared to control, FEV1 decreased and P0.1/(VT/Ti) increased (p less than 0.01 for both). After bronchoconstriction was reversed by administration of a beta 2-agonist bronchodilator (fenoterol), a significant decrease in P0.1/(VT/Ti) (p less than 0.001) and a significant increase in FEV1 (p less than 0.01) were noted as compared to histamine. With histamine, change in P0.1/(VT/Ti) was found to be related to its pre-histamine value (p less than 0.01). Furthermore, with histamine and fenoterol, changes in P0.1/(VT/Ti) and concurrent changes in FEV1 were found to be significantly related (p less than 0.001). From these data we calculated that the P0.1/(VT/Ti) ratio provides a useful tool in the clinical assessment of histamine-induced bronchospasm.
对18名无症状哮喘患者进行组胺吸入激发试验，使用磷酸组胺加压气雾剂，剂量逐渐增加。测量1秒用力呼气量（FEV1）、通过口腔阻断压（P0.1）评估的总神经肌肉输出、平均吸气流量（VT/Ti）以及代表呼吸系统有效吸气阻抗指数的P0.1/(VT/Ti)比值。与对照组相比，使用组胺后，FEV1降低，P0.1/(VT/Ti)升高（两者均p<0.01）。在给予β2-激动剂支气管扩张剂（非诺特罗）逆转支气管收缩后，与组胺相比，P0.1/(VT/Ti)显著降低（p<0.001），FEV1显著升高（p<0.01）。使用组胺时，发现P0.1/(VT/Ti)的变化与其组胺前值相关（p<0.01）。此外，使用组胺和非诺特罗时，发现P0.1/(VT/Ti)的变化与FEV1的同时变化显著相关（p<0.001）。根据这些数据我们计算得出，P0.1/(VT/Ti)比值为组胺诱导的支气管痉挛的临床评估提供了一个有用的工具。
