Riedler J, Reade T, Robertson C F
Department of Thoracic Medicine, Royal Children's Hospital, Victoria, Australia.
Pediatr Pulmonol. 1994 Nov;18(5):330-6. doi: 10.1002/ppul.1950180511.
Non-isotonic aerosols are being used more commonly to perform bronchial provocation tests. In contrast to histamine and methacholine challenge tests they appear to have higher specificity and a higher predictive value. The aim of the present study was to assess the reproducibility of the response to challenge with 4.5% hypertonic saline administered via an ultrasonic nebulizer in children with mild to severe asthma. Seventeen children with asthma aged 10 to 14 years completed two or three challenge tests at the same time of day within a 10 day period. Of these 17 children 9 had mild, 4 moderate, and 4 severe asthma. Children inhaled 4.5% hypertonic NaCl from an ultrasonic nebulizer with an output of 1.9 to 2.5 mL/min (Timeter) using the protocol developed by Anderson with modifications. A fall in forced expiratory volume in 1 second (FEV1) from baseline of 15% or more was considered a positive response and PD15 was calculated. In 16/17 subjects a greater than 15% fall in FEV1 occurred consistently on all study days. One subject with moderate asthma had a less than 15% fall in FEV1 on both study days. The coefficient of repeatability for PD15 was 1.8. This equals 0.85 of a doubling dose difference between the two or three measurements of PD15. The cumulative time of aerosol inhalation causing a fall in FEV1 > or = 15%) (PT15) showed a coefficient of repeatability of 1.59, similar to 0.67 doubling dose difference. The PD15 and PT15 were highly significantly correlated. The 4.5% NaCl challenge test yields good reproducibility in children with mild to severe asthma under laboratory conditions.
非等渗气雾剂越来越常用于进行支气管激发试验。与组胺和乙酰甲胆碱激发试验相比，它们似乎具有更高的特异性和更高的预测价值。本研究的目的是评估通过超声雾化器给予4.5%高渗盐水对轻至重度哮喘患儿进行激发试验时反应的可重复性。17名10至14岁的哮喘患儿在10天内于同一天的同一时间完成了两到三次激发试验。在这17名患儿中，9名患有轻度哮喘，4名患有中度哮喘，4名患有重度哮喘。患儿按照Anderson制定并经修改的方案，从输出量为1.9至2.5 mL/分钟的超声雾化器（Timeter）中吸入4.5%的高渗氯化钠。一秒用力呼气容积（FEV1）较基线下降15%或更多被视为阳性反应，并计算PD15。在16/17名受试者中，所有研究日FEV1均持续下降超过15%。一名中度哮喘患儿在两个研究日FEV1下降均小于15%。PD15的重复性系数为1.8。这相当于PD15两次或三次测量之间加倍剂量差异的0.85。导致FEV1下降≥15%的气雾剂吸入累积时间（PT15）的重复性系数为1.59，相当于加倍剂量差异的0.67。PD15和PT15高度显著相关。在实验室条件下，4.5%氯化钠激发试验在轻至重度哮喘患儿中具有良好的可重复性。
