Sekerel B E, Saraçlar Y, Kalayci O, Cetinkaya F, Tuncer A, Adalioğlu G
Department of Pediatrics, School of Medicine, Hacettepe University, Ankara, Turkey.
Allergy. 1997 Nov;52(11):1106-9. doi: 10.1111/j.1398-9995.1997.tb00183.x.
Although several tests are available to assess the presence and severity of bronchial hyperresponsiveness (BHR), there is no agreement on the most appropriate stimulus. The most commonly used stimuli are methacholine, histamine, and exercise. Daily peak expiratory flow (PEF) variation has been reported to correlate with the severity of BHR, and in recent years this has been widely used because of its noninvasiveness and ease of performance. This study was carried out to determine the relationship among these four commonly used measures of bronchial responsiveness in asthmatic children. For this purpose, 12 asthmatic children of varying disease severity were recruited. Subjects underwent three challenges on 3 separate days in 1 week. During the week preceding the challenges (methacholine, histamine, and exercise), patients recorded PEF three times a day. All patients had PC20 less than 8 mg/ml with methacholine and histamine. Patients with PC20 greater than 3.5 mg/ml for both methacholine or histamine had negative exercise challenges. The strongest correlation was between histamine and methacholine (r = 0.95). Exercise-induced bronchospasm had substantial and significant correlation with the other three measures. No significant correlation was observed between PEF variability and histamine or methacholine. The varying degrees of relationships among the four commonly used measures suggests that each method yields information on different but related phenomena. More than one measure may be required to detect the different aspects of asthmatic bronchial responsiveness.
尽管有多种测试可用于评估支气管高反应性（BHR）的存在及其严重程度，但对于最合适的刺激物尚无定论。最常用的刺激物是乙酰甲胆碱、组胺和运动。据报道，每日呼气峰值流速（PEF）变化与BHR的严重程度相关，近年来，由于其非侵入性和操作简便，它已被广泛应用。本研究旨在确定这四种常用的哮喘儿童支气管反应性测量方法之间的关系。为此，招募了12名病情严重程度各异的哮喘儿童。受试者在1周内的3个不同日子接受了三次激发试验。在进行激发试验（乙酰甲胆碱、组胺和运动）前的一周内，患者每天记录三次PEF。所有患者对乙酰甲胆碱和组胺的PC20均小于8mg/ml。对乙酰甲胆碱或组胺的PC20大于3.5mg/ml的患者运动激发试验结果为阴性。组胺与乙酰甲胆碱之间的相关性最强（r = 0.95）。运动诱发的支气管痉挛与其他三种测量方法有显著相关性。未观察到PEF变异性与组胺或乙酰甲胆碱之间有显著相关性。这四种常用测量方法之间不同程度的关系表明，每种方法都能提供关于不同但相关现象的信息。可能需要不止一种测量方法来检测哮喘支气管反应性的不同方面。
