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Measurement of bronchial hyperreactivity: comparison of three Nordic dosimetric methods.
Scandinavian Journal of Clinical and Laboratory Investigation ( IF 1.3 ) Pub Date : 2020-02-07 , DOI: 10.1080/00365513.2020.1719541
Paul G Lassmann-Klee 1 , Britt-Marie Sundblad 2 , Leo P Malmberg 3 , Anssi R A Sovijärvi 1 , Päivi Piirilä 1
Affiliation  

Clinical testing of bronchial hyperreactivity (BHR) provides valuable information in asthma diagnostics. Nevertheless, the test results depend to a great extent on the testing procedure: test substance, apparatus and protocol. In Nordic countries, three protocols predominate in the testing field: Per Malmberg, Nieminen and Sovijärvi methods. However, knowledge of their equivalence is limited. We aimed to find equivalent provocative doses (PD) to obtain similar bronchoconstrictive responses for the three protocols. We recruited 31 patients with suspected asthma and health care workers and performed BHR testing with methacholine according to Malmberg and Nieminen methods, and with histamine according to Sovijärvi. We obtained the individual response-dose slopes for each method and predicted equivalent PD values. Applying a mixed-model, we found significant differences in the mean (standard error of mean) response-dose (forced expiratory volume in one second (FEV1)%/mg): Sovijärvi 7.2 (1.5), Nieminen 13.8 (4.2) and Malmberg 26 (7.3). We found that the earlier reported cut-point values for moderate BHR and marked BHR between the Sovijärvi (PD15) and Nieminen (PD20) methods were similar, but with the Malmberg method a significant bronchoconstrictive reaction was measured with lower PD20 values. We obtained a relationship between slope values and PD (mg) between different methods, useful in epidemiological research and clinical practice.

中文翻译:

支气管高反应性的测量:三种北欧剂量法的比较。

支气管高反应性(BHR)的临床测试为哮喘诊断提供了有价值的信息。然而,测试结果在很大程度上取决于测试程序:测试物质,设备和规程。在北欧国家,测试领域中主要使用三种协议:Per Malmberg,Nieminen和Sovijärvi方法。但是,其等效性的知识是有限的。我们旨在找到等效的激发剂量(PD),以针对三种方案获得类似的支气管收缩反应。我们招募了31名怀疑患有哮喘和医护人员的患者,并根据Malmberg和Nieminen的方法用乙酰甲胆碱进行了BHR测试,根据Sovijärvi进行了组胺进行了BHR测试。我们获得了每种方法的个体响应剂量斜率,并预测了等效的PD值。应用混合模型 我们发现,平均剂量(平均标准误)响应剂量(一秒钟用力呼气量(FEV1)%/ mg)存在显着差异:Sovijärvi7.2(1.5),Nieminen 13.8(4.2)和Malmberg 26(7.3)。我们发现,较早报道的Sovijärvi(PD15)和Nieminen(PD20)方法之间的中度BHR切点值和明显的BHR值相似,但使用Malmberg方法时,PD20值较低时可测量到显着的支气管收缩反应。我们获得了不同方法之间的斜率值与PD(mg)之间的关系,可用于流行病学研究和临床实践。我们发现,较早报道的Sovijärvi(PD15)和Nieminen(PD20)方法之间的中度BHR切点和明显的BHR相似,但使用Malmberg方法时,PD20值较低时可测得显着的支气管收缩反应。我们获得了不同方法之间的斜率值与PD(mg)之间的关系,可用于流行病学研究和临床实践。我们发现,较早报道的Sovijärvi(PD15)和Nieminen(PD20)方法之间的中度BHR切点值和明显的BHR值相似,但使用Malmberg方法时,PD20值较低时可测量到显着的支气管收缩反应。我们获得了不同方法之间的斜率值与PD(mg)之间的关系,可用于流行病学研究和临床实践。
更新日期:2020-04-18
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