Chen W Y, Yu J, Wang J Y
Department of Pediatrics, Kaohsiung Medical College, Taiwan.
Asian Pac J Allergy Immunol. 1994 Jun;12(1):15-20.
Bronchial hyperresponsiveness (BHR) to methacholine were evaluated in 47 asthmatic children before and after allergen-specific immunotherapy (IT) by using the forced oscillation method. Eighty-seven percent (13/16) of BHR-negative patients had good clinical response after 1-year immunotherapy while there were only 45% (14/31) in the BHR-positive asthmatic children (p < 0.02). In the BHR-positive group, the relationship between clinical response and the change of nonspecific bronchial sensitivity was further analyzed. In those of good clinical response (IT responder), the tolerance dose of methacholine was significantly increased from 0.78 +/- 0.71 to 4.11 +/- 4.65 mg/ml (p < 0.05), and bronchial sensitivity increased from 1.14 +/- 1.42 U to 7.55 +/- 9.55 U (p < 0.02). In those with no clinical improvement (IT non-responder), there were no significant changes in either methacholine tolerance dose or bronchial sensitivity. With respect to other parameters, such as Grs, PD35, and SGrs, the differences between before and after immunotherapy were similar in both the IT responders and IT non-responders. These results suggest that asthmatic children with different bronchial sensitivity had different responses to immunotherapy and the clinical improvement after immunotherapy is significantly related to the improvement of bronchial hyperresponsiveness.
采用强迫振荡法，对47例哮喘儿童在变应原特异性免疫治疗（IT）前后的支气管对乙酰甲胆碱的高反应性（BHR）进行了评估。16例BHR阴性患者中有87%（13/16）在1年免疫治疗后有良好的临床反应，而BHR阳性的哮喘儿童中只有45%（14/31）有良好临床反应（p<0.02）。在BHR阳性组中，进一步分析了临床反应与非特异性支气管敏感性变化之间的关系。在临床反应良好的患者（IT反应者）中，乙酰甲胆碱的耐受剂量从0.78±0.71显著增加至4.11±4.65mg/ml（p<0.05），支气管敏感性从1.14±1.42U增加至7.55±9.55U（p<0.02）。在无临床改善的患者（IT无反应者）中，乙酰甲胆碱耐受剂量和支气管敏感性均无显著变化。关于其他参数，如Grs、PD35和SGrs，免疫治疗前后IT反应者和IT无反应者的差异相似。这些结果表明，支气管敏感性不同的哮喘儿童对免疫治疗有不同反应，免疫治疗后的临床改善与支气管高反应性的改善显著相关。
