Kremer A M, Pal T M, Oldenziel M, Kerkhof M, de Monchy J G, Rijcken B
Dept of Epidemiology, University Hospital Groningen, The Netherlands.
Eur Respir J. 1995 May;8(5):737-41.
A shortened histamine challenge test was used in a study of occupational airway disease. We evaluated the safety, defined as the absence of a decrease in forced expiratory volume in one second (FEV1) of greater than 40%. The occurrence of complaints, the repeatability of test results, and the average amount of time saved were measured. A standard protocol was used comprising 30 s tidal breathing with sequential doubling concentrations from 1 to 32 mg.ml-1 histamine. Subjects with no indication of hyperresponsive airways started at 4 mg.ml-1. If the decrease in FEV1 was < 6%, a concentration step was skipped (fourfold increase in concentration). The test was terminated when the decrease in FEV1 was at least 18%. A total of 697 subjects performed a test. All subjects with a provocative concentration of histamine producing a 20% decrease in FEV1 (PC20) value of < or = 4 mg.ml-1 (n = 16) started at the lowest concentration. Six subjects reached a > or = 20% decrease in FEV1 (range 21-24%) after a fourfold increase in concentration. Five subjects had a decrease in FEV1 of greater than 40%, and this decrease occurred after a doubling concentration. Cough, flushing, and chest tightness were noted in 18% of the subjects. In 56% of the tested subjects, the shortest provocation scheme (phosphate solution followed by 4, 16 and 32 mg.ml-1 histamine) was applied, resulting in a time reduction of nearly 50% per test, and reducing the time needed to complete the study from 5 to 3 months. The shortened test was repeatable within one concentration difference.(ABSTRACT TRUNCATED AT 250 WORDS)
在一项职业性气道疾病研究中采用了缩短版组胺激发试验。我们评估了安全性，其定义为一秒用力呼气容积（FEV1）下降不超过40%。记录了不适症状的出现情况、测试结果的可重复性以及节省的平均时间。使用了标准方案，包括30秒潮气呼吸，组胺浓度从1至32mg.ml-1依次翻倍。气道无高反应迹象的受试者从4mg.ml-1开始。如果FEV1下降<6%，则跳过一个浓度步长（浓度四倍增加）。当FEV1下降至少18%时终止测试。共有697名受试者进行了测试。所有组胺激发浓度导致FEV1下降20%（PC20）值≤4mg.ml-1的受试者（n = 16）从最低浓度开始。6名受试者在浓度四倍增加后FEV1下降≥20%（范围21 - 24%）。5名受试者FEV1下降超过40%，且这种下降发生在浓度翻倍之后。18%的受试者出现咳嗽、脸红和胸闷。56%的受试对象采用了最短激发方案（磷酸盐溶液后接4、16和32mg.ml-1组胺），每次测试时间减少近50%，并将完成研究所需时间从5个月减至3个月。缩短版测试在一个浓度差异内具有可重复性。（摘要截断于250字）
