Abstract:Objective To compare the advantages and disadvantages between exercise challenge test (ECT) and methacholine challenge test (MCT) in the measurement of airway hyperresponsiveness (AHR), in order to identify a better and safer method to measure AHR. Methods Forty-seven children with controlled asthma after regular treatment were enrolled. ECT and MCT were performed for each child successively, and sensitivity was obtained through comparison with the golden standard (PD20). The occurrence of bronchospasm symptoms during the two tests was recorded. Results Taking PD20 as the gold standard, in children with moderate or severe AHR, the sensitivity of MCT (61%) for the measurement of AHR was significantly higher than that of ECT (9%) (Pκ=0.614), while the consistency between ECT results and PD20 was relatively low (κ=0.006). However, in the MCT, the incidence of bronchospasm symptoms was high and positively correlated with the incidence of cough and chest distress (PConclusions MCT has a higher sensitivity for the measurement of AHR, but has a higher incidence of adverse events, compared with ECT in children with controlled asthma after regular treatment.
ZHAI Ting-Ting,PAN Jia-Hua. Comparison of clinical application of exercise challenge test and methacholine challenge test in measurement of airway hyperresponsiveness[J]. CJCP, 2015, 17(10): 1066-1069.
Leuppi JD. Bronchoprovocation tests in asthma:direct versus indirect challenges[J]. Curr Opin Pulm Med, 2014, 20(1):31-36.
[2]
Global Initiative for Asthma. Pocket guide for asthma management and prevention (for adults and children older than 5 years)[DB/OL]. (2013-5-15) [2013-10-20].
Parsons JP, Hallstrand TS, Mastronarde JG, et al. An official American Thoracic Society clinical practice guideline:exerciseinduced bronchoconstriction[J]. Am J Respir Crit Care Med, 2013, 187(9):1016-1027.
[7]
Crapo RO, Casaburi R, Coates AL, et al. Guidelines for methacholine and exercise challenge testing-1999[J]. Am J Respir Crit Care Med, 2000, 161(1):309-329.
[8]
Guan W, Zheng J, Gao Y, et al. Leukotriene D4 and methacholine bronchial provocation tests for identifying leukotriene-responsiveness subtypes[J]. Allergy Clin Immunol, 2013, 131(2):332-338.
Muñoz-López F, Ríos-Alcolea M. The interest of FEF (25-75) in evaluating bronchial hyperresponsiveness with the methacholine test[J]. Allergol Immunopathol, 2012, 40(6):352-356.
Pasnick SD, Carlos WG 3rd, Arunachalam A, et al. Exerciseinduced bronchoconstriction[J]. Ann Am Thorac Soc, 2014, 11(10):1651-1652.
[13]
Segel MJ, Rabinovich E, Schwarz Y, et al. Methacholine challenge testing:improved patient comfort with a 2-tiered protocol[J]. Ann Allergy Asthma Immunol, 2013, 110(6):429-432.