Hedman J, Alanko K, Nieminen M M
Department of Pulmonary Diseases, Päijät-Häme Central Hospital, Lahti, Finland.
Clin Physiol. 1996 Jul;16(4):353-9. doi: 10.1111/j.1475-097x.1996.tb00724.x.
The repeatability of a rapid dosimetric method for methacholine challenge was evaluated with 11 asthmatic patients. A Spira Elektro 2 dosimeter was used for methacholine delivery and a pocket turbine spirometer (Micro Spirometer) for FEV1 measurements. Methacholine was delivered in four successive, increasing doses ranging from 80 micrograms up to a cumulative dose of 6900 micrograms. The single determination standard deviation was low (12.5%), corresponding to a 95% confidence interval of +/- 0.925 doubling doses. The mean difference (+/- SE) between measurements of log PD20 FEV1 was -0.015 (0.056), and the absolute value of the difference in log PD20 FEV1 was not significantly related to the average log PD20 FEV1 (r = -0.155, P = 0.65). The rapid dosimetric methacholine challenge test, performed with a pocket turbine spirometer, proved to be as reproducible as previous methods. Furthermore, this methacholine challenge is clearly less time consuming than conventional provocations, including bronchodilator aerosol (given to resolve post-challenge bronchoconstriction); the whole test can be performed in 20 min. This is especially valuable in epidemiologic studies, as well as in clinical practice.
对11名哮喘患者评估了一种快速乙酰甲胆碱激发试验剂量测定方法的可重复性。使用Spira Elektro 2剂量计输送乙酰甲胆碱，并用便携式涡轮肺活量计（微型肺活量计）测量第一秒用力呼气容积（FEV1）。以连续递增的四剂方式输送乙酰甲胆碱，剂量范围从80微克至累积剂量6900微克。单次测定的标准差较低（12.5%），对应于95%置信区间为±0.925倍剂量。对数PD20 FEV1测量值之间的平均差异（±标准误）为-0.015（0.056），且对数PD20 FEV1差异的绝对值与平均对数PD20 FEV1无显著相关性（r = -0.155，P = 0.65）。使用便携式涡轮肺活量计进行的快速剂量测定乙酰甲胆碱激发试验，其可重复性与先前方法相同。此外，这种乙酰甲胆碱激发试验明显比传统激发试验耗时少，包括用于缓解激发后支气管收缩的支气管扩张气雾剂；整个试验可在20分钟内完成。这在流行病学研究以及临床实践中尤其有价值。
