Kopferschmitt-Kubler M C, Bessot J C, Pauli G
Service de Pneumologie, Hôpital Civil, Hôpitaux Universitaires de Strasbourg.
Rev Mal Respir. 1993;10(3):209-15.
The contribution and the relevance of bronchial provocation tests to allergens have been evaluated in the realm of clinical research and in the diagnosis of the aetiology of asthma. These tests enable the recognition or to confirm the role of certain allergens in asthma, as well as to study the delayed reaction which occurs in some cases after the inhalation of an allergen as well as the relations existing between HRBNS and bronchial provocation tests to allergens. They also can show the preventative action of certain drugs on the immediate and/or delayed reaction induced by allergens. The methodology of bronchial provocation tests to allergens, notably their variability and their reproductibility, as well as the initial and maximal inhaled doses that can be realistically used, are discussed. The final point touched upon concerns the justification of bronchial provocation tests to allergens in the aetiological diagnosis of asthma. The indications of these tests have been restricted, they seen nonetheless always to be of interest in cases of discordance with the clinical history, cutaneous tests and/or measures of specific serum IgE.
在临床研究领域以及哮喘病因诊断中,已经对支气管激发试验针对过敏原的作用及相关性进行了评估。这些试验能够识别或确认某些过敏原在哮喘中的作用,还能研究在吸入过敏原后某些情况下出现的迟发反应,以及非特异性支气管高反应性(HRBNS)与支气管过敏原激发试验之间存在的关系。它们还可以显示某些药物对过敏原诱导的速发和/或迟发反应的预防作用。文中讨论了支气管过敏原激发试验的方法,尤其是其变异性和可重复性,以及实际可使用的初始和最大吸入剂量。最后涉及的一点是支气管过敏原激发试验在哮喘病因诊断中的合理性。这些试验的适应证已经受到限制,但在与临床病史、皮肤试验和/或特异性血清IgE检测结果不一致的情况下,它们似乎始终具有重要意义。