哮喘联盟

   摘要
   背景：运用脉冲振荡法(IOS)评估阻力频率依赖性(R5-20)是一种测定小气道功能的方法。有小气道参与的支气管收缩可反映出成人哮喘的严重程度。
   目的：本研究旨在评估乙酰甲胆碱(Mch)引起的R5-20变化是否与幼儿运动诱发性支气管收缩(EIB)的严重程度有关。
   方法：共有109例3-8岁的儿童纳入研究，其中95例伴有气道阻塞症状，14例健康状况良好，通过乙酰甲胆碱激发试验评估小气道功能。分别于基线和使用乙酰甲胆碱激发后测定R5-20、其他IOS阻力及电抗参数。通过标准化运动测试，根据运动后、频率为5 Hz时阻力增加的百分比为标准评价支气管收缩的严重程度，对儿童进行如下分组：无支气管收缩(ΔR5 < 40%, n = 84)、中度支气管收缩(ΔR5 40-80%, n = 13)、重度支气管收缩(ΔR5 > 80%, n = 12)。
   结果：基线R5-20与支气管收缩严重程度无关，但是乙酰甲胆碱诱发支气管收缩引起的R5-20变化，重度支气管收缩的儿童（增加2.61倍）显著高于中度支气管收缩的儿童(1.48)或无支气管收缩的儿童(1.74, p = 0.036)。其他IOS参数的变化无显著相关性。重度支气管收缩的儿童最近两个月短效β受体激动剂的使用也多于其他两组(p < 0.001)。
   结论：乙酰甲胆碱诱发支气管收缩的过程中可运用脉冲振荡法(IOS)评估阻力频率依赖性(R5-20)，β受体激动剂使用频繁与幼儿严重支气管收缩有关。
 

（杨冬 审校）
Respir Med. 2015 Dec19.pii:S0954-6111(15)30097-4.doi:10.1016/j.rmed.2015.12.006. [Epub ahead of print]

 

Aberrant small airways function relates to asthma severity in young children.
 

Kalliola S1, Malmberg LP2, Pelkonen AS2, Mäkelä MJ2.
 

Abstract
BACKGROUND:Frequency dependence of resistance (R5-20) assessed by impulse oscillometry (IOS) is suggested to be a measure of small airways. Small airways involvement during induced bronchoconstriction has been shown to reflect severity of asthma in adults.
OBJECTIVE:Our aim was to evaluate if methacholine (Mch) induced changes in R5-20 are associated with the severity of exercise induced bronchoconstriction (EIB) in young children.
METHODS:A total of 109 children aged 3-8 years were studied, 95 with obstructive symptoms and 14 in good health, to assess small airways function during a Mch challenge. R5-20 and other IOS resistance and reactance parameters were measured at baseline and after the Mch challenge. In a standardized exercise test, the children were grouped according to the severity of EIB expressed as the percentage increase in resistance at 5 Hz (ΔR5) after exercise, indicating either no EIB (ΔR5 < 40%, n = 84), moderate EIB (ΔR5 40-80%, n = 13) and severe EIB (ΔR5 > 80%, n = 12).
RESULTS:The baseline R5-20 was not associated with the severity of EIB, but during Mch induced bronchoconstriction the change in R5-20 was significantly higher in children with severe EIB (2.61 fold increase) than in children with moderate EIB (1.48) or no EIB (1.74, p = 0.036). No significant associations were found in changes of other IOS parameters. The children with severe EIB also used more short-acting beta-agonists during the past two months than the other two groups (p < 0.001).
CONCLUSION:Frequency dependence of resistance (R5-20) measured by IOS during the Mch induced bronchoconstriction and more frequent use of beta-agonists are associated with severe EIB in young children.
 

Respir Med. 2015 Dec19.pii:S0954-6111(15)30097-4.doi:10.1016/j.rmed.2015.12.006. [Epub ahead of print]