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变应性鼻炎气道功能的季节性变化

Seasonal variation of airway function in allergic rhinitis.

作者信息

Gerblich A A, Schwartz H J, Chester E H

出版信息

J Allergy Clin Immunol. 1986 May;77(5):676-81. doi: 10.1016/0091-6749(86)90408-2.

DOI:10.1016/0091-6749(86)90408-2
PMID:3700890
Abstract

We set out to examine seasonal variation in airway bronchoconstriction in patients with seasonal allergic rhinitis. Airway conductance and response to methacholine challenge were measured during pollen season, as well as in winter when pollen exposure was not present. Airway conductance and spirometry were performed on 17 subjects during allergy season and in winter. In eight of these subjects the measurements were repeated in the successive allergy season. Methacholine bronchoprovocation was performed on 17 of the subjects in winter and in eight subjects in allergy season. We found airway constriction in both allergy seasons as evidenced by specific airway conductance (SGaw) of 0.188 +/- 0.06 and 0.203 +/- 0.03. In contrast, SGaw during winter was 0.27 +/- 0.11. When winter and summer seasons were compared, both summer SGaw values were significantly lower than winter SGaw, p less than 0.01 and p less than 0.05, respectively. Mean airway sensitivity to methacholine during allergy season was 16.1 breath units and not different than out of season 11.7 breath units; p = NS. The reactivity to methacholine (slope of the dose-response curve) and spirometry (FVC, FEV1, FEV1/FVC) in and out of allergy season were likewise not different. The data indicate that patients with allergic rhinitis have unique physiologic behavior separating them from patients with asthma or normal subjects. They develop seasonal bronchoconstriction unassociated with clinical bronchospasm, but this seasonal bronchoconstriction does not potentiate their sensitivity to methacholine. However, they have increased airway sensitivity to methacholine, and this feature distinguishes them from normal subjects.

摘要

我们着手研究季节性变应性鼻炎患者气道支气管收缩的季节性变化。在花粉季节以及不存在花粉暴露的冬季,测量气道传导率和对乙酰甲胆碱激发试验的反应。在过敏季节和冬季,对17名受试者进行气道传导率和肺量测定。其中8名受试者在随后的过敏季节重复测量。在冬季对17名受试者进行乙酰甲胆碱支气管激发试验,在过敏季节对8名受试者进行该试验。我们发现,两个过敏季节均存在气道收缩,特异性气道传导率(SGaw)分别为0.188±0.06和0.203±0.03,可资证明。相比之下,冬季的SGaw为0.27±0.11。将冬季和夏季进行比较时,两个夏季的SGaw值均显著低于冬季的SGaw,p值分别小于0.01和小于0.05。过敏季节期间对乙酰甲胆碱的平均气道敏感性为16.1呼吸单位,与非过敏季节的11.7呼吸单位无差异;p =无显著性差异。过敏季节期间和非过敏季节期间对乙酰甲胆碱的反应性(剂量-反应曲线的斜率)和肺量测定(用力肺活量、第1秒用力呼气量、第1秒用力呼气量/用力肺活量)同样无差异。数据表明,变应性鼻炎患者具有独特的生理行为,将他们与哮喘患者或正常受试者区分开来。他们出现与临床支气管痉挛无关的季节性支气管收缩,但这种季节性支气管收缩不会增强他们对乙酰甲胆碱的敏感性。然而,他们对乙酰甲胆碱的气道敏感性增加,这一特征将他们与正常受试者区分开来。

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