Britton J, Pavord I, Richards K, Knox A, Wisniewski A, Wahedna I, Kinnear W, Tattersfield A, Weiss S
Respiratory Medicine Unit, City Hospital, Nottingham, UK.
Eur Respir J. 1994 May;7(5):881-7.
The factors that determine the occurrence of airway hyperreactivity in the general population are not clearly understood. This study was designed to assess the independent effects of age, atopy, smoking and airway calibre. In a random sample of 2,415 adults aged 18-70 yrs we measured reactivity to methacholine as the dose provoking a 20% fall (PD20) in one-second forced expiratory volume (FEV1), atopy as the mean skin wheal response to three common environmental allergens, and airway calibre as the baseline FEV1 in absolute terms, as percent predicted (FEV1 % predicted) and as percent forced vital capacity (FEV1 % FVC). Hyperreactivity, defined as a PD20 < or = 12.25 mumol, was present in 314 (13%) of the sample, and before adjustment for FEV1 was more common in females (independent odds ratio (OR) = 2.05 (95% confidence interval 1.6-2.7)), current smokers (OR = 1.89 (1.3-2.6)), atopics (OR = 1.39 (1.3-1.5) per mm skin wheal), and in older age groups (OR for age 60-70 yrs relative to 18-29 yrs = 2.70 (1.7-4.3)). However, the odds of hyperreactivity were also strongly and independently related to absolute FEV1 (OR = 0.46 (0.27-0.77) per litre), FEV1 % predicted (OR = 0.96 (0.94-0.98) per percent), and FEV1 % FVC (OR = 0.92 (0.90-0.94) per percent; combined chi-square on 3 df = 312, p << 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)
一般人群中决定气道高反应性发生的因素尚不清楚。本研究旨在评估年龄、特应性、吸烟和气道管径的独立影响。在一个由2415名年龄在18 - 70岁的成年人组成的随机样本中，我们测量了对乙酰甲胆碱的反应性，以引起一秒用力呼气量（FEV1）下降20%的剂量（PD20）来表示；特应性以对三种常见环境过敏原的平均皮肤风团反应来衡量；气道管径则以绝对的基线FEV1、预测值百分比（FEV1%预测值）和用力肺活量百分比（FEV1% FVC）来表示。定义为PD20≤12.25μmol的高反应性在314名（13%）样本中存在，在调整FEV1之前，女性（独立比值比（OR）= 2.05（95%置信区间1.6 - 2.7））、当前吸烟者（OR = 1.89（1.3 - 2.6））、特应性个体（每毫米皮肤风团的OR = 1.39（1.3 - 1.5））以及年龄较大的组（60 - 70岁相对于18 - 29岁的OR = 2.70（1.7 - 4.3））中更常见。然而，高反应性的几率也与绝对FEV1（每升OR = 0.46（0.27 - 0.77））、FEV%预测值（每百分比OR = 0.96（0.94 - 0.98））和FEV1% FVC（每百分比OR = 0.92（0.90 - 0.94）；3自由度的联合卡方检验= 312，p << 0.0001）密切且独立相关。（摘要截断于250字）
