Le Souëf P N, Sears M R, Sherrill D
Department of Respiratory Medicine, Princess Margaret Hospital for Children, Perth, Australia.
Am J Respir Crit Care Med. 1995 Aug;152(2):576-9. doi: 10.1164/ajrccm.152.2.7633710.
Methodologies used to assess airway responsiveness (AR) in children administer the same dosage schedule to all children despite the great range in the size of subjects. The aim of this study was to examine the hypothesis that the level of AR is size dependent within same-age cohorts and between different ages. Among a birth cohort of 1,037 New Zealand children participating in a longitudinal study, 818 had at least two measurements of airway responsiveness between ages 9 and 15 yr. Each child performed spirometry and a four-dose methacholine inhalation test. A continuous slope index of methacholine responsiveness was computed. AR slope indexes were analyzed using longitudinal methods, which included an indicator variable for subjects who reported having any wheeze. AR was lowest in both males and females in the upper quartile for height than those in the lower quartile, independently of age. AR tended to be higher (responded to lower concentrations of methacholine) in boys than girls and to decline with age among wheezers. The greater level of responsiveness in smaller or younger children could be explained by these individuals having received a dose of methacholine that was relatively large for their size.
用于评估儿童气道反应性（AR）的方法，对所有儿童都采用相同的给药方案，尽管受试者的体型差异很大。本研究的目的是检验以下假设：在同年龄队列以及不同年龄之间，AR水平与体型有关。在参与一项纵向研究的1037名新西兰儿童出生队列中，818名儿童在9至15岁之间至少进行了两次气道反应性测量。每个儿童都进行了肺活量测定和四剂量乙酰甲胆碱吸入试验。计算了乙酰甲胆碱反应性的连续斜率指数。使用纵向方法分析AR斜率指数，其中包括一个针对报告有任何喘息症状的受试者的指示变量。无论年龄如何，身高处于上四分位数的男性和女性的AR均低于下四分位数者。男孩的AR往往高于女孩（对较低浓度的乙酰甲胆碱有反应），并且在喘息儿童中随年龄下降。较小或较年幼儿童的反应性较高，可能是因为这些个体接受的乙酰甲胆碱剂量相对于其体型来说较大。
