Methacholine Inhalation Challenge Test在診斷學齡兒童之氣管氣喘之價值

Methacholine Inhalation Challenge Test乃利用膽鹼激素刺激支氣管收縮，藉支氣管有無出現異常反應以診斷支氣管氣喘。為瞭解國內學齡兒童支氣管異常反應之陽性情況及試圖瞭解支氣管氣喘與Methacholine Inhalation Challenge Test陽性間之關係，自1991年9月至1992年4月間，我們共蒐集了正濱國中二年級學生299位實施本項檢查，除了7位（2位頭部外傷後遺症，1位低智商，4位無法配合）無法測試外，共292位學生完成本項檢查。結果在292位受檢者中，有67位呈陽性反應，陽性率為22.9％。有氣喘病史者11位，9位呈陽性反應，陽性率為81.8％。在陽性反應中，我們發現有氣喘病史者較傾向於中度或高度之支氣管異常反應，而無氣喘病史之陽性受檢者則傾向於輕度反應，以Fisher's Exact Test分析結果具顯著性差異（X2=16.1, P=0.00093），而有哮喘史，個人過敏史，家族過敏史或有家族氣喘史者其支氣管異常反應較常人為高。

關鍵字

支氣管異常反應；磷酸緩衝液

並列摘要

Objective: to assess the bronchial hyperresponsiveness in school children, we have modified Tiffeneau's procedure to establish a simple and reliable provocative test which we have found exceedingly useful in our clinic. Method: During a 6 months period from September 1991 to April 1992, 292 students were tested with methacholine. All subjects had been free of any respiratory infection or drugs for at least 3 weeks. A drop in FEV1 of 20% or greater from the baseline with any of the standard concentrations of methacholine is considered positive for the test. Results: The difference in response between the asthma and non-asthma subjects is highly significant (p=0.0004). The difference in response between the group with wheezing history, allergy history, wheezing in test, asthma in family, allergy or atopy in family and non-group are also highly signiflicant (p=0.024, p=0.0014, p=0.007, p=0.0016, p=0.033). Conclusion: In general, bronchial hyperresponsiveness is more severe in asthma group than in non-asthma group. High risk group includes wheezing history, allergy history, wheezing in test, asthma in family and allergy or atopy in family. Since bronchial hyperreactivity to methacholine may be a predictor of the future development of asthma, the 58 non-asthma positive subjects should be long term follow up.

並列關鍵字

Methacholine inhalation challange test ； asthma ； children

國際替代計量

Methacholine Inhalation Challenge Test在診斷學齡兒童之氣管氣喘之價值

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