Pennings H J, Wouters E F
Dept of Pulmonology, University Hospital Maastricht, The Netherlands.
Eur Respir J. 1997 Mar;10(3):665-71.
Isocapnic hyperventilation with cold air (IHCA) is a reliable technique for assessing indirect bronchial hyperresponsiveness in patients with asthma. Impedance measurement of the respiratory system by the forced pseudorandom noise oscillation technique is a sensitive technique to assess changes in bronchial tone after IHCA. The aim of this study was to evaluate the effect of 6 weeks of treatment with beclomethasone dipropionate, 1,000 microg x day-1, on IHCA in asthmatic patients, measured with both forced oscillation technique and flow-volume recordings. Forty patients with mild asthma were included in this double-blind, placebo-controlled parallel-group study. Stratification on the basis of sex was performed to overcome differences in airway diameter. At entry and every 2 weeks during the treatment period, IHCA was performed and patient diaries were evaluated. Characteristic changes in forced oscillation parameters after IHCA were observed in all patients. After 6 weeks of treatment, BDP-treated patients showed statistically significant differences in impedance measurements after IHCA, manifested by significant attenuation of resistance at 8 Hz (p<0.01), slope of the frequency-resistance curve (p<0.01), reactance at 8 Hz (p=0.01), and resonant frequency (f0) (p<0.02). Flow-volume recordings showed only a statistically significant change in the decrease of inspiratory vital capacity (IVC) (p=0.01). Furthermore, a significant correlation was observed between serum immunoglobulin E (IgE) levels and the effect of BDP on IHCA, measured with forced oscillation technique. In this study, beclomethasone dipropionate, 1,000 microg x day(-1) for 6 weeks, decreased indirect bronchial hyperresponsiveness as assessed by cold air bronchoprovocation in asthmatic patients. The forced oscillation technique proved a more sensitive method of detecting changes in bronchial tone than flow-volume recordings.
冷空气等容性过度通气（IHCA）是评估哮喘患者间接支气管高反应性的可靠技术。通过强迫伪随机噪声振荡技术进行呼吸系统的阻抗测量是评估IHCA后支气管张力变化的敏感技术。本研究的目的是评估1000μg/天的二丙酸倍氯米松治疗6周对哮喘患者IHCA的影响，采用强迫振荡技术和流量-容积记录进行测量。40例轻度哮喘患者纳入了这项双盲、安慰剂对照的平行组研究。基于性别进行分层以克服气道直径的差异。在入组时以及治疗期间每2周进行一次IHCA，并评估患者日记。所有患者均观察到IHCA后强迫振荡参数的特征性变化。治疗6周后，BDP治疗组患者在IHCA后的阻抗测量中显示出统计学显著差异，表现为8Hz时阻力显著降低（p<0.01）、频率-阻力曲线斜率（p<0.01）、8Hz时电抗（p=0.01）和谐振频率（f0）（p<0.02）。流量-容积记录仅显示吸气肺活量（IVC）下降有统计学显著变化（p=0.01）。此外，在用强迫振荡技术测量时，观察到血清免疫球蛋白E（IgE）水平与BDP对IHCA的影响之间存在显著相关性。在本研究中，1000μg/天的二丙酸倍氯米松治疗6周可降低哮喘患者经冷空气支气管激发试验评估的间接支气管高反应性。强迫振荡技术被证明是一种比流量-容积记录更敏感的检测支气管张力变化的方法。
