OBJECTIVETo 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.

METHODSForty-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.

RESULTSTaking 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%) (P<0.05). The consistency between MCT results and PD20 was relatively high (κ=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 (P<0.05).

CONCLUSIONSMCT 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.