Turner D J, Landau L I, LeSouëf P N
Department of Respiratory Medicine, Princess Margaret Hospital for Children, Perth, Australia.
Pediatr Pulmonol. 1993 Feb;15(2):98-104. doi: 10.1002/ppul.1950150206.
The relationship between age and bronchodilator responsiveness (BDR) in children has not been studied using objective parameters. The aim of this study was to seek such a relationship in young asthmatic children using dose-response curves (DRC). Fourteen asthmatic subjects (age 3-9 years) with a forced expiratory volume in 1 sec (FEV1) less than 80% predicted were studied after being trained to use a spirometer reliably. Each subject completed a DRC by inhaling 5 doses of salbutamol (albuterol) at 15 min intervals until a cumulative total of 6.84 mg of salbutamol had been administered. FEV1, forced vital capacity (FVC), and forced expiratory flow at mid vital capacity (FEF25-75) were measured before and after each nebulization. In addition, arterial oxygen saturation (SaO2) and heart rate (HR) were measured in some of the subjects. All lung function parameters, SaO2 and HR increased significantly between baseline and completion of the DRC. A significant age effect on BDR was detected in FEV1 and FVC, with older children showing a greater response than young ones. The response had plateaued after the maximum dose in the younger but not in the older children. These findings suggest that the level of response to a bronchodilator increases significantly with increasing age in young asthmatics.
尚未使用客观参数研究儿童年龄与支气管扩张剂反应性（BDR）之间的关系。本研究的目的是利用剂量反应曲线（DRC）在哮喘患儿中探寻这种关系。对14名年龄在3至9岁、第一秒用力呼气量（FEV1）低于预测值80%的哮喘受试者进行了研究，这些受试者在接受可靠使用肺活量计的训练后参与研究。每位受试者每隔15分钟吸入5剂沙丁胺醇（舒喘灵），直至累计给予6.84毫克沙丁胺醇，从而完成一条剂量反应曲线。在每次雾化前后测量FEV1、用力肺活量（FVC）和用力肺活量中期的用力呼气流量（FEF25-75）。此外，还对部分受试者测量了动脉血氧饱和度（SaO2）和心率（HR）。在基线至剂量反应曲线完成期间，所有肺功能参数、SaO2和HR均显著增加。在FEV1和FVC方面检测到年龄对支气管扩张剂反应性有显著影响，年龄较大的儿童比年龄较小的儿童反应更大。较年幼儿童在最大剂量后反应已趋于平稳，而年龄较大的儿童则没有。这些发现表明，在年轻哮喘患者中，对支气管扩张剂的反应水平随年龄增长而显著增加。
