Burrows B, Sears M R, Flannery E M, Herbison G P, Holdaway M D, Silva P A
Respiratory Sciences Center, University of Arizona College of Medicine, Tucson 85724, USA.
Am J Respir Crit Care Med. 1995 Oct;152(4 Pt 1):1302-8. doi: 10.1164/ajrccm.152.4.7551386.
Bronchial responsiveness to methacholine was measured in a birth cohort of New Zealand children at ages 9, 11, 13, and 15. Overall bronchial hyperresponsiveness (BHR) decreased with age. While the response at age 9 was significantly related to responsiveness, symptom severity, and low lung function at age 15, these relationships were much closer when bronchial response levels after age 9 were taken into account. Also, among children who were unresponsive to methacholine at age 15, those with previous BHR had more frequent wheeze and lower lung function than those whose previous tests were all unresponsive. Both the overall tendency to BHR and the tendency to retain BHR were closely related to high serum IgE levels (determined at age 11) and to positive allergy skin tests (determined at age 13). These evidences of allergy, closely related to the severity and course of methacholine response, appeared to be important determinants of the frequency of wheeze and the degree of impairment of lung function at the end of follow-up. In view of the variability in BHR, a single estimate of bronchial responsiveness taken at an arbitrary point in time may not be an accurate index of the overall tendency to BHR.
在一个新西兰儿童出生队列中，分别于9岁、11岁、13岁和15岁时测量了支气管对乙酰甲胆碱的反应性。总体而言，支气管高反应性（BHR）随年龄增长而降低。虽然9岁时的反应与15岁时的反应性、症状严重程度和低肺功能显著相关，但在考虑9岁以后的支气管反应水平时，这些关系更为密切。此外，在15岁时对乙酰甲胆碱无反应的儿童中，既往有BHR的儿童比既往检查均无反应的儿童喘息更频繁，肺功能更低。BHR的总体趋势和维持BHR的趋势均与高血清IgE水平（在11岁时测定）和阳性过敏皮肤试验（在13岁时测定）密切相关。这些与乙酰甲胆碱反应的严重程度和病程密切相关的过敏证据，似乎是随访结束时喘息频率和肺功能损害程度的重要决定因素。鉴于BHR的变异性，在任意时间点进行的单一支气管反应性估计可能不是BHR总体趋势的准确指标。
