Mochizuki H, Shigeta M, Kato M, Maeda S, Shimizu T, Mirokawa A
Department of Pediatrics, Gunma University School of Medicine, Maebashi, Japan.
Am J Respir Crit Care Med. 1995 Sep;152(3):906-10. doi: 10.1164/ajrccm.152.3.7663803.
To evaluate the influence of aging on bronchial hyperreactivity (BHR) during the childhood period, age-related changes in bronchial reactivity to methacholine (BRm) in children from 2 to 13 yr of age were studied using the same method, employing a methacholine inhalation challenge with transcutaneous oxygen pressure (tcPO2) monitoring. Three hundred and thirty-nine asthmatic subjects (male:female = 200:139, aged [mean +/- SEM] 7.2 +/- 0.2 yr) and 107 age-matched controls (male:female = 55:52, aged 5.3 +/- 0.3 yr) were enrolled in this study. TcPO2 was measured by a tcPO2 monitor, and subsequent doses of methacholine were then doubled until a 10% decrease in tcPO2 from its baseline value was reached. The cumulative dose of methacholine at the inflection point of tcPO2 (Dmin-PO2) was considered to represent the BRm. For the sake of comparison, respiratory resistance (Rr) in subjects more than 6 yr old was measured by the oscillation technique during methacholine inhalation challenge, and the threshold point of Rr (Dmin-Rr) was also considered to represent the BRm. In the asthmatic children aged 2 to 7 yr, Dmin-PO2 decreased significantly from 12.2 +/- 2.1 to 3.1 +/- 0.8 units, but after age 8 yr the values gradually increased from 3.1 +/- 0.7 to 6.4 +/- 1.6 units. In children aged 6 to 13 yr, Dmin-Rr showed the same increase as Dmin-PO2, from 2.0 +/- 0.5 to 5.8 +/- 1.4 units. These age-related changes in BRm reflected in both Dmin-PO2 and Dmin-Rr were also seen in the age-matched controls.(ABSTRACT TRUNCATED AT 250 WORDS)
为评估儿童期衰老对支气管高反应性(BHR)的影响,采用相同方法,通过经皮氧分压(tcPO₂)监测的乙酰甲胆碱吸入激发试验,研究了2至13岁儿童支气管对乙酰甲胆碱反应性(BRm)的年龄相关变化。本研究纳入了339名哮喘患者(男∶女 = 200∶139,年龄[均值±标准误]7.2±0.2岁)和107名年龄匹配的对照者(男∶女 = 55∶52,年龄5.3±0.3岁)。用tcPO₂监测仪测量tcPO₂,随后乙酰甲胆碱剂量加倍,直至tcPO₂从基线值下降10%。tcPO₂拐点处的乙酰甲胆碱累积剂量(Dmin-PO₂)被视为代表BRm。为作比较,对6岁以上受试者在乙酰甲胆碱吸入激发试验期间采用振荡技术测量呼吸阻力(Rr),Rr的阈值点(Dmin-Rr)也被视为代表BRm。在2至7岁的哮喘儿童中,Dmin-PO₂从12.2±2.1单位显著降至3.1±0.8单位,但8岁后该值从3.1±0.7单位逐渐增至6.4±1.6单位。在6至13岁儿童中,Dmin-Rr与Dmin-PO₂表现出相同的增加,从2.0±0.5单位增至5.8±1.4单位。年龄匹配的对照者中也出现了Dmin-PO₂和Dmin-Rr所反映的BRm的这些年龄相关变化。(摘要截短至250字)