Vandenplas O, Malo J L, Pauli G
Cliniques Universitaires UCL de Mont-Godinne, Yvoir, Belgique.
Rev Mal Respir. 1994;11(2):189-99.
The relationship between occupational asthma (OA) and non-specific bronchial responsiveness (NSBR) is reviewed. Natural or laboratory exposure to ubiquitous allergens can induce or increase NSBR. Reduction of exposure has an opposite effect. Preliminary results suggest that NSBR is not a predisposing factor to OA. NSBR assessment can be useful in screening for OA, before employment to document baseline levels and serially afterwards, alone or combined to immediate skin reactivity to the occupational agent, to document the onset of OA. Showing NSBR is essential to the diagnosis of OA. Although specific broncho-provocation tests in a hospital laboratory still represent the gold standard to confirm OA, the demonstration of changes in peak expiratory flow rates, in particular if such changes are coupled to NSBR, is an important diagnostic tool. NSBR assessment is also an interesting guide to specific bronchoprovocation in the laboratory. Several studies have documented a reduction in NSBR in some cases of OA after removal from exposure to the causal agent. The degree of NSBR is one of the criteria that have been suggested in setting permanent disability in subjects with OA. Increased NSBR can exist in other occupational conditions and represents an essential feature of Reactive Airways Dysfunction Syndrome (RADS).
本文综述了职业性哮喘（OA）与非特异性支气管反应性（NSBR）之间的关系。自然环境或实验室环境中普遍存在的过敏原暴露可诱发或增加NSBR。减少暴露则会产生相反的效果。初步结果表明，NSBR并非OA的诱发因素。NSBR评估在OA筛查中可能有用，可在就业前记录基线水平，之后定期进行，单独或与对职业性致病因子的即刻皮肤反应性相结合，以记录OA的发病情况。NSBR的出现对OA的诊断至关重要。尽管医院实验室中的特异性支气管激发试验仍是确诊OA的金标准，但呼气峰值流速变化的证明，特别是如果这种变化与NSBR相关联，是一种重要的诊断工具。NSBR评估也是实验室中特异性支气管激发试验的一个有趣指导。多项研究记录了一些OA病例在脱离致病因子暴露后NSBR降低。NSBR程度是在确定OA患者永久性残疾时所建议的标准之一。NSBR增加也可能存在于其他职业环境中，并且是反应性气道功能障碍综合征（RADS）的一个基本特征。
