摘要
在人群研究中,大多数受试者无法计算支气管收缩剂引起肺功能显著下降的刺激剂量(PD)。碳酰胆碱的剂量反应曲线研究来确定这种关系可以概括可能通过一个连续的指数计算对象,即两点剂量响应斜率(DRS)意味着抵抗(Rm)和抵抗10赫兹(R10)的强迫振荡技术(FOT)。71例因哮喘(16例)、慢性咳嗽(15例)、鼻息肉(8例)、慢性鼻炎(8例)、呼吸困难(8例)、荨麻疹(5例)、过敏性休克(4例)和其他疾病(7例)而就诊的患者分别吸入5剂卡巴醇(每剂320微克)。连续测量fet阻力和1秒用力呼气量(FEV1)。用内插法计算了碳醇的PD导致FEV1 >下降或= 20% (PD20)或Rm或R10 >上升或= 47% (PD47,Rm和PD47,R10)。以末次剂量变化百分比除以总剂量,得到FEV1 (DRSFEV1)、Rm (DRSRm)和R10 (DRSR10)的DRS值。采用受试者工作特征(ROC)曲线评价DRSRm、DRS10 delta%Rm和delta%R10检测肺活量支气管高反应性(BHR、FEV1 >下降或= 20%)的敏感性(Se)和特异性(Sp)。23人(32%)“肺活量的反应堆。PD20与drsev1相关性强(r=-0.962; p=0.0001); PD47,Rm correlated significantly with DRSRm (r=-0.648; p=0.0001) and PD47,R10 with DRSR10 (r=-0.552; p=0.0001). DRSFEV1 correlated significantly with both DRSRm (r=0.700; p=0.0001) and DRSR10 (r=0.784; p=0.0001). The Se and Sp of the various FOT indices to correctly detect spirometric BHR were as follows: DRSRm: Se=91.3%, Sp=81.2%; DRSR10: Se=91.3%, Sp=95.8%; delta%Rm: Se=86.9%, Sp=52.1%; and delta%R10: Se=91.3%, Sp=58.3%. Dose-response slopes of indices of forced oscillation technique resistance, especially the dose-response slope of resistance at 10Hz are proposed as simple quantitative indices of bronchial responsiveness which can be calculated for all subjects and that may be useful in occupational epidemiology.