气道高渗盐水反应性与运动诱发性哮喘症状严重程度以及组胺或乙酰甲胆碱反应性的关系。

Relation of the hypertonic saline responsiveness of the airways to exercise induced asthma symptom severity and to histamine or methacholine reactivity.

作者信息

Makker H K, Holgate S T

机构信息

University of Southampton, Southampton General Hospital.

出版信息

Thorax. 1993 Feb;48(2):142-7. doi: 10.1136/thx.48.2.142.

DOI:10.1136/thx.48.2.142

PMID:8493628

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC464291/

Abstract

BACKGROUND

Conflicting views exist over whether responsiveness of the airways to hypertonic saline relates to non-specific bronchial hyperresponsiveness measured by histamine or methacholine challenge. The bronchoconstrictor responses to exercise and hypertonic saline are reported to be closely related, but the relationship between the symptoms of exercise induced asthma and airway responsiveness to hypertonic saline is not known.

METHODS

In 29 asthmatic patients with a history of exercise induced asthma, the response to an ultrasonically nebulised hypertonic saline (3.6% sodium chloride) aerosol, measured as the volume of hypertonic saline laden air required to produce a fall in forced expiratory volume in one second (FEV1) of > or = 20% (PD20), was compared with the concentration of histamine (PC20; group 1) and methacholine (PC20; group 2) producing a 20% fall in baseline FEV1 and exercise induced asthma symptom severity score (groups 1 and 2). The hypertonic responsiveness was determined in a dose-response manner to a maximum dose of 310 1 and the exercise induced asthma symptom severity was scored on a scale of 0-5.

RESULTS

Of the 29 patients, 23 (79%) were responsive to the hypertonic saline, with PD20 values ranging from 9 to 310 1. A significant correlation was found between the PD20 hypertonic saline and the exercise induced asthma symptom score. There was no significant correlation between the PD20 response to hypertonic saline and the histamine PC20 or methacholine PC20. The exclusion of those subjects who failed to respond to hypertonic saline improved the relationship between hypertonic saline and methacholine PC20. No significant correlation was found between the exercise induced asthma symptom score and histamine PC20 or methacholine PC20.

CONCLUSION

These findings suggest that hypertonic saline responsiveness bears a closer relationship to the severity of exercise induced asthma symptoms than to the non-specific bronchial hyperresponsiveness measured by histamine or methacholine reactivity.

摘要

背景

关于气道对高渗盐水的反应性是否与通过组胺或乙酰甲胆碱激发试验测得的非特异性支气管高反应性相关，存在相互矛盾的观点。据报道，运动和高渗盐水引起的支气管收缩反应密切相关，但运动诱发哮喘症状与气道对高渗盐水的反应性之间的关系尚不清楚。

方法

在29例有运动诱发哮喘病史的哮喘患者中，将超声雾化高渗盐水（3.6%氯化钠）气雾剂的反应（以一秒用力呼气量（FEV1）下降≥20%所需的含高渗盐水空气量（PD20）来衡量）与引起基线FEV1下降20%的组胺浓度（PC20；第1组）和乙酰甲胆碱浓度（PC20；第2组）以及运动诱发哮喘症状严重程度评分（第1组和第2组）进行比较。以剂量反应方式确定高渗反应性，最大剂量为310 1，并将运动诱发哮喘症状严重程度按0-5级评分。

结果

29例患者中，23例（79%）对高渗盐水有反应，PD20值范围为9至310 1。高渗盐水PD20与运动诱发哮喘症状评分之间存在显著相关性。高渗盐水PD20反应与组胺PC20或乙酰甲胆碱PC20之间无显著相关性。排除那些对高渗盐水无反应的受试者后，高渗盐水与乙酰甲胆碱PC20之间的关系得到改善。运动诱发哮喘症状评分与组胺PC20或乙酰甲胆碱PC20之间无显著相关性。