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目的比较白三烯D4作为支气管激发剂与乙酰甲胆碱在激发过程中致患者咳嗽、胸闷、气促等副反应的发生率,及恢复速率。方法 73例哮喘患者分别进行LTD4和乙酰甲胆碱支气管激发试验,比较激发剂致患者肺功能下降20%时引起咳嗽、胸闷和气促等不适症状视觉近似评分(VAS)。激发剂进行激发试验后,患者肺功能恢复正常时患者不适症状缓解情况。结果乙酰甲胆碱激发试验导致患者FEV1下降20%时VAS评分为6.0(3.0),较LTD4所致VAS评分4.0(2.0)增高明显,具有统计学意义(P<0.05)。终止激发吸入万托林缓解症状,肺功能FEV1恢复到80%时,MCh引起的患者不适症状VAS评分为2.0(2.0)分,而LTD4引起的VAS评分为0.0(1.0)分,具有统计学差异(P<0.05)。结论 LTD4作为支气管激发剂较乙酰甲胆碱导致患者咳嗽、胸闷、气促等症状少,且患者主观不适症状轻微,吸入万托林后白三烯导致的不适症状可在5 min内迅速缓解,而乙酰甲胆碱导致的不适症状仍存在。
Objective To compare the incidence of cough, chest tightness, shortness of breath and other side effects of leukotriene D4 as a bronchial provocation agent and methacholine in the process of excitation and the recovery rate. Methods A total of 73 patients with asthma were subjected to LTD4 and methacholine bronchial provocation test. Compared with 20% decrease of lung function, the visual analogue scale (VAS) of cough, chest tightness and shortness of breath caused by the stimulant was significantly higher than that of the control group. Excitant stimulation test, patients with normal lung function returned to patients with symptoms of remission. Results The methacholine provocation test led to a VAS score of 6.0 (3.0) at a 20% fall in FEV1 and a statistically significant increase (P <0.05) over the VAS score of 4.0 due to LTD4 (2.0). The termination of provoked vantharin stimulation relieved symptoms and VAS score was 2.0 (2.0) for patients with MCh and 0.0 (1.0) for LTD4, with a statistically significant difference when pulmonary function FEV1 was restored to 80% (P <0.05). Conclusions LTD4 as a bronchial provocative agent causes less cough, chest tightness and shortness of breath than methacholine, and mild subjective discomfort in patients. The discomfort caused by levotetralin after inhalation of Wantropin can be quickly relieved within 5 min, Methacholine-induced discomfort remains.