Sparrow D, O'Connor G T, Weiss S T, DeMolles D, Ingram R H
Department of Veterans Affairs Outpatient Clinic, Boston, Massachusetts, USA.
Am J Respir Crit Care Med. 1997 Mar;155(3):888-92. doi: 10.1164/ajrccm.155.3.9117022.
In persons with asthma, a deep inhalation (DI) to total lung capacity may lead to bronchoconstriction. The intensity of this effect has been shown to correlate positively with the severity of inflammatory airflow obstruction and the level of methacholine airway responsiveness. The correlates of lung volume history effects in the general population, however, are unknown. We analyzed combined maximal and partial expiratory flow-volume data, pre- and postbronchodilator spirometry data, and methacholine challenge data from 89 middle-aged and older men participating in the Normative Aging Study. The ratio of maximal to partial expiratory flow rates (VM/VP) was significantly correlated with methacholine airway responsiveness, even after adjustment for age and baseline FEV1. The direction of this correlation indicated that men with higher VM/VP ratios (i.e., greater dilator effect of a DI) tended to have greater methacholine airway responsiveness. Subjects with a higher VM/VP ratio also tended to have a greater response to a bronchodilator. These results suggest that, in the general population, airway responsiveness relates in part to airway smooth muscle tone. The correlations suggest that this relatively simple maneuver might play a role in future epidemiologic studies.
对于哮喘患者，深吸气至肺总量可能会导致支气管收缩。这种效应的强度已被证明与炎症性气流阻塞的严重程度以及乙酰甲胆碱气道反应性水平呈正相关。然而，一般人群中肺容积历史效应的相关因素尚不清楚。我们分析了参与标准老化研究的89名中老年男性的最大呼气流量和部分呼气流量 - 容积联合数据、支气管扩张剂前后的肺量计数据以及乙酰甲胆碱激发试验数据。即使在调整年龄和基线第一秒用力呼气容积（FEV1）后，最大呼气流量与部分呼气流量之比（VM/VP）仍与乙酰甲胆碱气道反应性显著相关。这种相关性的方向表明，VM/VP比值较高（即深吸气的扩张效应较大）的男性往往具有更高的乙酰甲胆碱气道反应性。VM/VP比值较高的受试者对支气管扩张剂的反应也往往更大。这些结果表明，在一般人群中，气道反应性部分与气道平滑肌张力有关。这些相关性表明，这种相对简单的操作可能在未来的流行病学研究中发挥作用。
