Feinstein R A, LaRussa J, Wang-Dohlman A, Bartolucci A A
Division of Adolescent Medicine, University of Alabama at Birmingham, USA.
Clin J Sport Med. 1996 Apr;6(2):119-23. doi: 10.1097/00042752-199604000-00010.
To pilot test an exercise-induced asthma (EIA) screening program using a submaximal step-test and pulmonary function test (PFT) to identify athletes with EIA and to determine if a physical examination or self-reported history could be used to predict the existence of EIA.
Screening and diagnostic testing using a convenience sample.
Birmingham, Alabama, during athletic preparticipation examination (PPE).
Fifty-two African-American, male football players aged 14-18 years being evaluated for participation in scholastic athletics. No athlete refused participation. Four were excluded because of need for further evaluation unrelated to any pulmonary condition.
Each athlete completed a medical history, allergy history, physical examination, preexercise pulmonary function test (PFT), submaximal step-test, and a series of postexercise PFTs.
Major outcome measurements were changes in forced expiration volume in 1s (FEV1) or peak expiratory flow rate (PEFR) after completing an exercise challenge.
Seventeen of 48 athletes had a > or = 15% decrease in PEFR after exercise. Nine of 48 athletes had a > or = 15% decrease in FEV1 after exercise. The only self-reported item that differentiated subjects with normal and abnormal PFTs was a personal history of asthma (p < 0.05).
Many athletes can be identified as having abnormal PFTs by use of a submaximal step-test as an exercise challenge. Self-reporting questionnaires and PPEs do not appear to be sensitive enough to identify athletes with this condition. If validated by future studies, this protocol could be used for the diagnosis of EIA.
采用次极量阶梯试验和肺功能测试（PFT）对运动诱发哮喘（EIA）筛查项目进行初步试验，以识别患有EIA的运动员，并确定体格检查或自我报告的病史是否可用于预测EIA的存在。
使用便利样本进行筛查和诊断测试。
阿拉巴马州伯明翰市，在运动员参赛前检查（PPE）期间。
52名年龄在14 - 18岁的非裔美国男性足球运动员，他们正在接受参加学校体育活动的评估。没有运动员拒绝参与。4名运动员因需要进一步评估（与任何肺部疾病无关）而被排除。
每位运动员完成一份病史、过敏史、体格检查、运动前肺功能测试（PFT）、次极量阶梯试验以及一系列运动后PFT。
主要观察指标是完成运动挑战后1秒用力呼气量（FEV1）或呼气峰值流速（PEFR）的变化。
48名运动员中有17名在运动后PEFR下降≥15%。48名运动员中有9名在运动后FEV1下降≥15%。唯一能区分PFT正常和异常受试者的自我报告项目是哮喘个人史（p < 0.05）。
通过使用次极量阶梯试验作为运动挑战，可以识别出许多PFT异常的运动员。自我报告问卷和PPE似乎不够敏感，无法识别患有这种疾病的运动员。如果未来的研究验证有效，该方案可用于EIA的诊断。
