Modification of the methacholine inhalation test and its epidemiologic use in polyurethane workers.
Modification of the methacholine inhalation test and its epidemiologic use in polyurethane workers.
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乙酰甲胆碱吸入试验的修改及其在聚氨酯工人中的流行病学用途。
DOI：
10.1164/arrd.1986.133.4.600
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发表时间：
1986
期刊：
影响因子：
--
通讯作者：
Weill,H
中科院分区：
文献类型：
--
作者：
Hendrick,DJ;Fabbri,LM;Hughes,JM;Banks,DE;BarkmanJr,HW;Connolly,MJ;Jones,RN;Weill,H
测量支气管反应性的剂量计方法是将乙酰甲胆碱的累积剂量增加一倍，以控制一些潜在影响变量的影响。由DeVilbiss 646喷雾器产生的激发气雾剂的空气动力学质量中值直径为1.2μ，每次吸入的平均产量为8.9μ。累积剂量从0.3个乙酰甲胆碱吸入单位(1个单位=1个从1毫克/毫升乙酰甲胆碱溶液吸入的气雾剂，即8.9μg乙酰甲胆碱)到可能的640个单位，这被认为是避免不可接受的全身影响风险的合理最大值。反应性表示为引起FEV1下降20%(PD20)的剂量。对这一完整方案进行了修改，以便利流行病学调查。医生评估与呼吸功能基线测量相结合，允许高反应性概率较低的人从较高剂量开始，从而将测试所需时间缩短至平均38分钟。在一项对20名同时使用完全和修改方案的人进行的验证研究中，测量的PD20值之间没有发现显著差异(几何平均值完全方案和改进方案的几何平均值分别为14.83和14.88；r=0.99)。使用改进的方法测量了254名接触甲苯二异氰酸酯的工人的支气管反应性。事实证明，这是安全和可接受的。64名工人(25.2%)被发现是反应堆。PD20值的频率分布呈稳步上升趋势，符合单峰分布。
The dosimeter method of administering doubling cumulative doses of methacholine to measure bronchial responsiveness was standardized to control for the effects of a number of potential influencing variables. The aerodynamic mass median diameter of the challenge aerosol produced from a DeVilbiss 646 nebulizer proved to be 1.2μ, and the mean output per inhalation 8.9μ|.Each challenge dose comprised 5 inhalations. Cumulative doses ranged from 0.3 methacholine inhalation units (1 unit = 1 inhalation of aerosol from a 1-mg/ml solution of methacholine, i.e., 8.9 μg methacholine) to a possible 640 units, the maximum that was considered reasonable to avoid the risk of unacceptable systemic effects. Responsiveness was expressed as the dose provoking a 20% decline (PD20) in FEV1. Modifications in this full protocol were introduced to facilitate epidemiologic investigations. Physician assessments coupled with baseline measurements of ventilatory function allowed starting at higher dosages for persons with low probability of hyperresponsiveness, thereby shortening the time required for testing to an average of 38 min. In a validation study of 20 persons using both the full and modified protocols, no significant differences were detected between measured PD20values (geometric means Full versus Modified, 14.83 versus 14.88; r = 0.99). The modified protocol was used to measure bronchial responsiveness in 254 workers exposed to toluene diisocyanate. It proved to be safe and acceptable. Sixty-four workers (25.2%) were found to be reactors. The frequency distribution of the PD20values exhibited a steadily increasing trend, consistent with a unimodal distribution.