Assessment of airway hyperreactivity: comparison of forced spirometry and body plethysmography for methacholine challenge tests.

作者: F Nensa , W Marek , E Marek , HJ Smith , M Kohlhäufl

DOI: 10.1186/2047-783X-14-S4-170

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摘要: Bronchial challenge tests by inhalation of aerosolized methacholine (MCH) are commonly used in the clinical diagnosis airway hyperresponsiveness (AHR). While detection narrowing relies on patient's cooperation performing forced spirometry, body plethysmographic measurements resistance less depending and do not alter respiratory tract maximal maneuvers. Hence we compared both methods concerning their value correlation during MCH challenges patients with asthma. Cumulative test, consisting up to 5 steps, evaluated plethysmography each step were performed 155 bronchial Airway responses recorded at application (Master-Screen Body, Cardinal Health, Hochberg). At baseline test after crossing provocation dose (PD) threshold (PD+100 sReff), expirations FEV1, FVC, FEV1 %FVC measured. Using regression analysis parameters taking as covariate, could extrapolate missing spirometric values interpolate estimated when PD (PD-20 FEV1) between two consecutive measurements. The administered PD+100 doses for specific resistance, sRtot, sReff Rtot Reff, PD-20 %FVC. Regarding found a mild, moderate, or severe AHR 114 (75%), but only 50 (32%) according FEV1. A statistical showed strongly linear correlated no significant results spirometry challenges, be most sensitive parameter detect AHR. Raw is largely independent height gender facilitating interpretation carried out longitudinally.

参考文章(35)
P. M. O'Byrne, D. W. Cockcroft, E. F. Juniper, S. D. Anderson, J. L. Malo, P. H. Quanjer, Leonardo Fabbri, P. J. Sterk, Airway Responsiveness. Standardized Challenge Testing With Pharmacological, Physical and Sensitizing Stimuli in Adults. Report Working Party Standardization of Lung Function Tests, European Community for Steel and Coal. Official Statement of the European Respiratory Society The European respiratory journal. Supplement. ,vol. 16, pp. 53- 83 ,(1993)
P. J. Sterk, L. M. Fabbri, P. H. Quanjer, D. W. Cockcroft, P. M. O'Byrne, S. D. Anderson, E. F. Juniper, J.- L. Malo, Comparison of inspiratory effort in sniff-like aspiration reflex, gasping and normal breathing in cats European Respiratory Journal. ,vol. 6, pp. 53- 59 ,(1993) , 10.1183/09041950.053S1693
Andrew Jensen, Haytham Atileh, Bela Suki, Edward P. Ingenito, Kenneth R. Lutchen, Selected contribution: airway caliber in healthy and asthmatic subjects: effects of bronchial challenge and deep inspirations. Journal of Applied Physiology. ,vol. 91, pp. 506- 515 ,(2001) , 10.1152/JAPPL.2001.91.1.506
SCOTT T. WEISS, MARK L. VAN NATTA, ROBERT S. ZEIGER, Relationship between Increased Airway Responsiveness and Asthma Severity in the Childhood Asthma Management Program American Journal of Respiratory and Critical Care Medicine. ,vol. 162, pp. 50- 56 ,(2000) , 10.1164/AJRCCM.162.1.9811005
T. K. Lim, S. M. Ang, T. H. Rossing, E. P. Ingenito, R. H. Ingram, The effects of deep inhalation on maximal expiratory flow during intensive treatment of spontaneous asthmatic episodes. The American review of respiratory disease. ,vol. 140, pp. 340- 343 ,(1989) , 10.1164/AJRCCM/140.2.340
Rolf Merget, Rudolf A. Jörres, Evelyn Heinze, Michael G. Haufs, Dirk Taeger, Thomas Brüning, Development of a 1-concentration-4-step dosimeter protocol for methacholine testing. Respiratory Medicine. ,vol. 103, pp. 607- 613 ,(2009) , 10.1016/J.RMED.2008.10.010
Donald W Cockcroft, Beth E Davis, David C Todd, Audrey J Smycniuk, Methacholine Challenge: Comparison of Two Methods Chest. ,vol. 127, pp. 839- 844 ,(2005) , 10.1378/CHEST.127.3.839
R. Beasley, C. Page, L. Lichtenstein, Airway remodelling in asthma Clinical & Experimental Allergy Reviews. ,vol. 2, pp. 109- 116 ,(2002) , 10.1046/J.1472-9725.2.S4.1.X
Bernadine Camarri, Peter R. Eastwood, Nola M. Cecins, Philip J. Thompson, Sue Jenkins, Six minute walk distance in healthy subjects aged 55-75 years Respiratory Medicine. ,vol. 100, pp. 658- 665 ,(2006) , 10.1016/J.RMED.2005.08.003
P. K. Jeffery, Remodeling and Inflammation of Bronchi in Asthma and Chronic Obstructive Pulmonary Disease Proceedings of the American Thoracic Society. ,vol. 1, pp. 176- 183 ,(2004) , 10.1513/PATS.200402-009MS