氯醋甲胆碱与乙酰甲胆碱在支气管激发试验中的应用和安全性分析

Application and safety analysis of chloroacetylcholine and acetylcholine in bronchial stimulation test

目的比较氯醋甲胆碱与乙酰甲胆碱在支气管激发试验(BPT)中的应用效果与安全性。方法选取本院2023年1月至2023年12月的氯醋甲胆碱BPT报告(A组),2022年1月至2022年12月的乙酰甲胆碱BPT报告(B组)。将BPT影响变量纳入混杂因素,通过1比2倾向性评分匹配(PSM)使成人及儿童处理组组间均衡。比较PSM后两组的阳性率、BPT相关指标以及PSM前的不良反应等。结果PSM后的A组和B组在成人的BPT阳性率分别为26.74%(361/1350)、27.04%(730/2700);儿童的阳性率分别为26.11%(47/180)、28.06%(101/360);两组成人及儿童的BPT阳性率差异均无统计学意义(均P>0.05);两组成人PSM后BPT阳性者气道高反应性分级差异无统计学意义(P>0.05),两组儿童的支气管舒张用药情况、舒张后恢复用时差异无统计学意义(均P>0.05);PSM前A组中有4例(0.26%)出现不良反应,B组不良反应共21例(0.16%)。结论氯醋甲胆碱应用于BPT的诊断阳性率、激发后恢复时间与乙酰甲胆碱接近,其应用价值和安全性均较好,值得推广应用。

Objective To compare the efficacy and safety of chloroacetylcholine and acetylcholine in bronchial provocation test(BPT).Methods The BPT reports of chloroacetylcholine from January to December 2023 were selected as the group A and the BPT reports of acetylcholine from January 2022 to December 2022 as the group B.Incorporating BPT influencing variables into confounding factors,a 1:2 propensity score matching(PSM)was used to achieve inter group balance between adults and children.Their positive rate,BPT related indicators,and adverse reactions before PSM were compared between the two groups.Conclusion The positive rate of the groups A and B in adults after PSM were 26.74%(361/1350)and 27.04%(730/2700),respectively,and the positive rate of children were 26.11%(47/180)and 28.06%(101/360),respectively.There was no statistically significant difference in the positive rate of BPT between the two groups of adults and children(P>0.05).There was no statistically significant difference in the grading of airway hyperresponsiveness between the two groups of adult PSM positive individuals with BPT(P>0.05),and there was no statistically significant difference in the use of bronchodilator medication and post diastolic recovery time between the two groups of children(P>0.05).There were 4 cases(0.26%)of adverse reactions in the group A before PSM,and a total of 21 cases(0.16%)in the group B.Conclusion The diagnostic positive rate and recovery time after stimulation of methylcholine chloride in BPT are like those of acetylcholine,and its application value and safety are both good,which is worth promoting and applying.