支气管舒张试验对类似冠心病胸闷症状的支气管哮喘的鉴别诊断  

Clinical Differential Diagnosis in Bronchial Asthma Patients with Chest Tightness like Coronary Heart Disease by Bronchodilator Test

作　　者：俎德玲[1] 诸葛毅[2] 

机构地区：[1]浙江省衢州市人民医院内科,324000 [2]浙江省衢州学院医学系

出　　处：《中国全科医学》2004年第22期1642-1643,共2页Chinese General Practice

摘　　要：目的　探讨临床对类似冠心病胸闷症状的支气管哮喘的有效鉴别诊断方法 ,减少误诊的发生。方法　对以类似冠心病胸闷为主要症状的 18例哮喘患者 ,采用支气管舒张试验测定用力肺活量 (FVC)、 1秒钟用力呼气容积(FEV1)、呼气峰值流量 (PEF)等 ,以FVC、FEV1(至少增加 2 0 0ml)及PEF的改变率≥ 15 % ,判断为支气管舒张试验阳性。结果　 18例类似冠心病胸闷的患者 ,支气管舒张试验的FVC、FEV1、PEF的改变率均 >15 %。结论　支气管舒张试验对类似冠心病胸闷症状的支气管哮喘的鉴别诊断 ,是一种有效和安全的筛选方法。Objective To approach a clinical noninvasive effective method of differential diagnosis in bronchial asthma patients with chest tightness like coronary heart disease and to reduce the rate of misdiagnosis in these patients.Methods 18 patients with chest tightness like coronary heart disease were given a standardized physical examination and found no wheezing sound in their chest.Forced vital capacity (FVC),forced expiratory volume in one second (FEV1),peak expiratory flow (PEF) was measured.Bronchodilator response was positive if FVC,FEV1 improved ≥15%,with an absolute change 200 ml,from the baseline level,PEF improved ≥15% of predicted value after 200ug salbutamol was inhaled.Results In 18 patients,the change rate of FVC,FEV1 and PEF was over>15%.Conclusion It is an effective and safe method for differential diagnosis in bronchial asthma patients with chest tightness like coronary heart disease by bronchodilator tests.

关 键 词：支气管舒张试验 冠心病 胸闷症状 支气管哮喘 鉴别诊断 

分 类 号：R562.25[医药卫生—呼吸系统]