Airway responsiveness to methacholine during the natural menstrual cycle and the effect of oral contraceptives.
Airway responsiveness to methacholine during the natural menstrual cycle and the effect of oral contraceptives.
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自然月经周期期间气道对乙酰甲胆碱的反应以及口服避孕药的作用。
DOI：
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发表时间：
1987
期刊：
影响因子：
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通讯作者：
E. Daniel
中科院分区：
文献类型：
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作者：
E. F. Juniper;P. Kline;R. Roberts;F. Hargreave;E. Daniel
据报道，一些患有哮喘的妇女在月经前和月经期间症状恶化。我们研究了17名控制良好的哮喘患者在连续2个月经周期中对乙酰甲胆碱的气道反应性的变化，这些患者的呼吸道反应性范围很广。在10名有规律自然周期的妇女中，在月经开始前1周和月经开始后1周进行测量，以符合最高和最低的孕酮水平。导致FEV1下降的乙酰甲胆碱平均浓度(PC20)为1.49 mg/ml，与绝经后PC20的1.34 mg/ml无显著差异(P=0.45)。虽然只有10名受试者，但概率为96%，这表明两个阶段之间几乎没有任何差异。在7名服用口服避孕药的妇女中，在21天疗程结束后1周内测得的平均PC20为1.19毫克/毫升，与月经开始后重新服药前测得的0.97毫克/毫升无显著差异(P=0.17)。有效率为98%。在两组中，FEV1和药物使用在周期中没有差异，但在月经期间症状更严重。结果表明，在自然月经周期中发生的血清孕酮水平的波动不足以改变未经选择的哮喘妇女的呼吸道反应性。他们还证明，无论是自然周期的妇女还是使用避孕药的妇女，在周期中都会出现症状的变化，这些变化与血清孕酮水平或呼吸道反应性无关。
Exacerbations of symptoms have been reported in some women with asthma just prior to and during menstruation. We examined changes in airway responsiveness to methacholine during 2 consecutive menstrual cycles in 17 well-controlled asthmatics with a wide range of airway responsiveness. In 10 women with regular natural cycles, measurements were made 1 wk before and 1 wk after the start of menstruation to coincide with the highest and lowest progesterone levels. The mean concentration of methacholine to cause a fall in FEV1 of 20% (PC20) premenstruation was 1.49 mg/ml, which was not significantly different from the mean postmenstruation PC20 of 1.34 mg/ml (p = 0.45). Although there were only 10 subjects, the power was 96%, indicating little likelihood of any difference between the 2 phases. In 7 women taking oral contraceptives, the mean PC20, measured within 1 wk of completing a 21-day course, was 1.19 mg/ml, which was not different from the mean PC20 of 0.97 mg/ml measured after the start of menstruation but before restarting medication (p = 0.17). The power was 98%. In both groups, there was no difference in FEV1 or medication use during the cycle, but symptoms were worse during menstruation. The results suggest that the fluctuations in serum progesterone levels that occur during natural menstrual cycles are insufficient to alter airway responsiveness in an unselected sample of asthmatic women. They also demonstrate that changes in symptoms occur during the cycle both in women with natural cycles and those using contraceptives and that these changes are not related to serum progesterone levels or airway responsiveness.