RETROSPECTIVE ANALYSES OF METHACHOLINE INHALATION CHALLENGES

被引:19
作者
GOLDSTEIN, MF [1 ]
PACANA, SM [1 ]
DVORIN, DJ [1 ]
DUNSKY, EH [1 ]
机构
[1] HAHNEMANN UNIV, SCH MED, DEPT PEDIAT, ALLERGY & IMMUNOL SERV, PHILADELPHIA, PA 19102 USA
关键词
D O I
10.1378/chest.105.4.1082
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
We retrospectively analyzed 198 methacholine inhalation challenges (MICs) of symptomatic patients with normal results of lung examinations, spirometry, and chest radiographs. During MIC, five parameters (FEV(1), FEF25-75%, FVC, sGaw, TGV) were measured. Using established changes in these parameters at less than or equal to 8 mg/ml methacholine, there were 175 positive tests (no false positives) and 23 negative tests (15 true negatives, 5 false negatives, and 3 unavailable for follow-up). The MIC sensitivity determined by FEV(1) responses was significantly lower than the sensitivity using responses in either three (FEV(1), FEF25-75%, and FVC; p<0.001) or five (FEV(1), FEF25-75%, FVC, sGaw, and TGV; p<0.001) parameter sets. Sensitivities were 60.6 percent, 91.1 percent, and 97.2 percent, respectively. All positive MICs (100 percent) were identified by examining changes in the five-parameter set vs 97.3 percent in the three-parameter set; it was a significant difference at p<0.01. We conclude that the measurement and analysis of non-FEV(1) parameters in addition to FEV(1) significantly increases the sensitivity of the MIC.
引用
收藏
页码:1082 / 1088
页数:7
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