OBJECTIVES:To assess the prevalence of bronchial hyperresponsiveness (BHR) in a population of north Finland among subjects with no previous diagnosis of asthma or chronic bronchitis by using histamine and methacholine challenges. The agreement between the methods was also evaluated. STUDY DESIGN:An epidemiological study assessing the prevalence of BHR measured with 2 direct dosimetric challenge methods. METHODS; Seventy-nine randomly selected subjects (21-73 years) were studied; 67% had respiratory or allergic symptoms. The baseline spirometry was normal or showed mild obstruction. Bronchial challenges to methacholine and histamine were performed on each subject in a randomized order. Provocative doses inducing the decrease of FEV1 by 15% and 20% (PD15FEV1 and PD20FEV1) and dose response ratios (DDR) were calculated for both tests. RESULTS; BHR with the methacholine test (PD20FEV1 < or = 2.6 mg) was found in 20% and with the histamine test (PD15FEV1 < or = 1.6 mg) in 28% of subjects; the agreement was 80% (kappa 0.45; 95% CI 0.23-0.68). In staging the severity of BHR the methods had a good agreement (weighted kappa 0.64; CI 95% 0.46-0.82). Prevalence of BHR fulfilling the criteria of the both methods was 14%. CONCLUSIONS:The findings suggest that the prevalence of BHR in the population of north Finland with no previous diagnosis of asthma or chronic bronchitis is at least 14%, probably around 20%, assessed by histamine and methacholine challenge methods. The methods have a good agreement to be used for classifying the severity of BHR.

译文

目的:通过使用组胺和乙酰甲胆碱攻击,评估先前未诊断出哮喘或慢性支气管炎的芬兰北部人群中支气管高反应性(BHR)的患病率。还评估了方法之间的一致性。
研究设计:一项流行病学研究,评估通过2种直接剂量挑战方法测量的BHR患病率。方法;研究了79名随机选择的受试者(21-73岁); 67%有呼吸道或过敏性症状。基线肺活量测定正常或显示轻度阻塞。以随机顺序对每个受试者进行了对乙酰甲胆碱和组胺的支气管激发。两种测试均计算了引起FEV1降低15%和20%的激发剂量(PD15FEV1和PD20FEV1)和剂量反应比(DDR)。结果;在28%的受试者中发现有甲胆碱测试(PD20FEV1 <或= 2.6 mg)的BHR和组胺测试(PD15FEV1 <或= 1.6 mg)的BHR。一致性为80%(kappa 0.45; 95%CI 0.23-0.68)。在评估BHR的严重程度时,这些方法具有很好的一致性(加权Kappa为0.64; CI为95%0.46-0.82)。符合两种方法标准的BHR患病率为14%。
结论:研究结果表明,通过组胺和乙酰甲胆碱激发方法评估,在先前未诊断出哮喘或慢性支气管炎的芬兰北部人群中,BHR的患病率至少为14%,可能约为20%。该方法具有良好的一致性,可用于对BHR的严重程度进行分类。

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