Ryan G, Dolovich M B, Roberts R S, Frith P A, Juniper E F, Hargreave F E, Newhouse M T
Am Rev Respir Dis. 1981 Feb;123(2):195-9. doi: 10.1164/arrd.1981.123.2.195.
Comparison of methods of aerosol generation and inhalation is required to improve standardization of inhalation provocation tests. We compared two widely used methods in 10 asthmatics, by measuring the dose and distribution of radiolabeled aerosol deposited in the throat and lung, and the provocation concentration of inhaled histamine required to reduce the FEV1 by 20% (PC20). In one method, aerosol was generated by a DeVilbiss 646 nebulizer attached to a dosimeter, and was inhaled by 5 inspiratory capacity breaths. The measurements with each method were repeated once to determine the reproducibility of results. Both methods deposited the same dose in the lung, but the distribution of the dose was different; the dosimeter method deposited more aerosol in the throat and central airways. The PC20 obtained with each method was the same. The reproducibility of all measurements in the same subject was similar. The lung dose deposited by each method in different subjects varied to the same degree. The results indicated that the bronchial response to inhaled histamine can be measured as reliably using a nebulizer and tidal breathing as by a more complex dose-metering device. They also suggested that, when the methods are regulated as described, the PC20 will have the same clinical significance.
为提高吸入激发试验的标准化程度，需要对气溶胶生成和吸入方法进行比较。我们在10名哮喘患者中比较了两种广泛使用的方法，通过测量沉积在咽喉和肺部的放射性标记气溶胶的剂量和分布，以及使第一秒用力呼气容积（FEV1）降低20%所需的吸入组胺激发浓度（PC20）。在一种方法中，气溶胶由连接剂量计的德维比斯646雾化器产生，并通过5次吸气量呼吸吸入。每种方法的测量重复一次以确定结果的可重复性。两种方法在肺部沉积的剂量相同，但剂量分布不同；剂量计法在咽喉和中央气道沉积的气溶胶更多。每种方法获得的PC20相同。同一受试者所有测量的可重复性相似。每种方法在不同受试者中沉积的肺剂量变化程度相同。结果表明，使用雾化器和潮气呼吸测量吸入组胺的支气管反应与使用更复杂的剂量测量装置一样可靠。结果还表明，按照所述方法进行规范时，PC20将具有相同的临床意义。
