Renwick D S, Connolly M J
University of Manchester Department of Geriatric Medicine, Barnes Hospital, Cheadle, Cheshire, UK.
Age Ageing. 1997 Nov;26(6):435-40. doi: 10.1093/ageing/26.6.435.
the relationships between atopy and chronic airflow obstruction and bronchial hyperresponsiveness in adults are unclear. We measured airways calibre (FEV1), bronchial responsiveness, eosinophil count and total serum IgE in a random population sample of adults aged 45 years or older.
Caucasian adults (n = 783) were selected from the practice lists of local general practitioners using random number tables. Responders to a postal questionnaire were invited to attend for venous blood sampling and methacholine challenge (Newcastle dosimeter method).
the questionnaire response rate was 92.3% (723 subjects); 62.5% of subjects invited to attend did so. Attenders were slightly younger than the whole study population, but otherwise representative. Methacholine challenge was completed by 208 subjects. Geometric mean IgE level was higher in current smokers; both IgE and eosinophils were raised in subjects reporting asthma. Multiple regression showed a negative independent relationship between age- and sex-standardized eosinophils and baseline FEV1 and a positive relationship between standardized IgE score and level of bronchial responsiveness. Separate analysis of subjects aged <65 and > or =65 years showed that these relationships were only significant in older subjects.
airways calibre and level of bronchial responsiveness are associated with measures of atopy in older adults. Atopy should not be overlooked as a factor in elderly patients with asthma or chronic airflow obstruction.
特应性与成人慢性气流受限及支气管高反应性之间的关系尚不清楚。我们在一个45岁及以上成年人的随机人群样本中测量了气道口径（第一秒用力呼气容积）、支气管反应性、嗜酸性粒细胞计数及血清总IgE水平。
使用随机数字表从当地全科医生的执业名单中选取白种人成年人（n = 783）。对邮寄问卷调查做出回应的人被邀请前来进行静脉血采样及乙酰甲胆碱激发试验（纽卡斯尔剂量计法）。
问卷调查的回应率为92.3%（723名受试者）；受邀前来的受试者中有62.5%前来参加。前来参加者比整个研究人群略年轻，但在其他方面具有代表性。208名受试者完成了乙酰甲胆碱激发试验。当前吸烟者的几何平均IgE水平较高；报告患有哮喘的受试者中IgE和嗜酸性粒细胞均升高。多元回归分析显示，年龄和性别标准化的嗜酸性粒细胞与基线第一秒用力呼气容积之间存在负向独立关系，标准化IgE评分与支气管反应性水平之间存在正向关系。对年龄<65岁和≥65岁的受试者进行单独分析显示，这些关系仅在老年受试者中具有显著性。
气道口径和支气管反应性水平与老年人的特应性指标相关。在患有哮喘或慢性气流受限的老年患者中，特应性作为一个因素不应被忽视。
