游泳和冷空气运动员的哮喘、气道炎症和上皮损伤
2009/05/18
关键词：气道高反应性；气道炎症；哮喘；运动员；上皮损伤
为了评价训练对游泳和冷空气运动员的气道反应性、炎症和上皮损伤的长期作用，Bougault等对64位优秀运动员(32位游泳运动员和32位冷空气运动员)进行了研究，同时将32例轻度哮喘患者和32健康者作为研究对照。所有研究对象均进行皮肤过敏针刺实验、乙酰胆碱激发实验和诱导痰分析。
研究发现，69%的游泳运动员和28%的冷空气运动员有气道高反应性。痰中性粒细胞数量与每周训练时间有关。游泳运动员的嗜酸性粒细胞数量高于健康对照，但低于哮喘患者，且与气道高反应性成正相关。冷空气运动员的嗜酸性粒细胞数量与健康对照者相当。与健康对照和哮喘患者相比，游泳运动员的支气管上皮细胞数量明显增多，但与气道高反应性无关。
综合研究结果，作者认为具有气道高反应性的运动员存在明显的气道炎症，而大多数优秀运动员存在的支气管上皮细胞损伤可能导致气道高反应性的发生。
（韩伟 青岛市市立医院东院呼吸科 266071 摘译）
（Eur Respir J 2009; 33:740-746）
Eur Respir J. 2009 Apr;33(4):740-6.
Asthma, airway inflammation and epithelial damage in swimmers and cold-air athletes.Bougault V, Turmel J, St-Laurent J, Bertrand M, Boulet LP.
Keywords: Airway hyperresponsiveness, airway inflammation, asthma, athletes, epithelial damage
Endurance athletes show an increased prevalence of airway hyperresponsiveness. The aim of the present study was to evaluate the long-term effects of training on airway responsiveness, inflammation and epithelial damage in swimmers and cold-air athletes. In total, 64 elite athletes (32 swimmers and 32 cold-air athletes), 32 mild asthmatic subjects and 32 healthy controls underwent allergy skin prick testing, methacholine challenge and induced sputum analysis. Overall, 69% of swimmers and 28% of cold-air athletes had airway hyperresponsiveness. Sputum neutrophil count correlated with the number of training hours per week in both swimmers and cold-air athletes. Eosinophil counts were higher in swimmers than in healthy subjects, although they were lower than in asthmatic subjects, and correlated with airway hyperresponsiveness in swimmers only. The eosinophil count in cold-air athletes was similar to that in healthy subjects. Bronchial epithelial cell count was not correlated with airway hyperresponsiveness but was significantly increased in swimmers, compared with healthy and asthmatic controls. In conclusion, the present authors observed significant airway inflammation only in competitive athletes with airway hyperresponsiveness. However, the majority of elite athletes showed evidence of bronchial epithelial damage that could possibly contribute to the development of airway hyperresponsiveness.
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