高原地区慢性阻塞性肺疾病与支气管哮喘患者气道阻塞可逆性对比研究  

Comparison of the bronchial obstruction reversibility in patients with chronic obstructive pulmonary disease and with asthma at high altitude

作　　者：杨生岳[1] 冯恩志[1] 沈君礼[1] 张瑛[1] 高玲[1] 赵丽红[1] 吴雪梅[1] 

机构地区：[1]解放军第四医院呼吸内科,青海西宁810014

出　　处：《西北国防医学杂志》2005年第3期170-172,共3页Medical Journal of National Defending Forces in Northwest China

基　　金：全军医药卫生科研基金资助项目(01MB014)

摘　　要：目的:探讨高原地区慢性阻塞性肺疾病(COPD)患者气道阻塞的可逆性,并与哮喘患者对比。方法:用SpirolabⅡ全自动肺功能仪测定COPD和哮喘患者吸入盐酸特布他林气雾剂前后肺通气功能,并进行了比较。结果:①COPD组和哮喘组的基础肺通气功能无显著差异性(P>0.05);②吸药后,两组患者的肺通气功能各项指标均明显改善(P<0.01),但COPD患者的改变率显著小于哮喘组(P<0.01);COPD单纯型组各项指标均有显著改善(P均<0.05),但改善率显著小于喘息型组(P<0.01),喘息型组改善率仍显著小于哮喘组(P均<0.01);③COPD患者中有15.2%支气管舒张试验阳性,哮喘患者中93.3%支气管舒张试验阳性。结论:COPD患者气道阻塞具有一定可逆性,但可逆性程度明显低于哮喘患者。β2-受体激动剂对高原COPD患者有明显的治疗作用。Objective: To explore the bronchial obstruction reversibility in patients with chronic obstructive pulmonary disease at high altitude, and to conduct a comparison with that in patients with asthma . Methods: The pulmonary ventilation function of patients with chronic obstructive pulmonary disease ( COPD) and with asthma before and after inhaling terbutaline inhaler was separately determined with spirolab Ⅱ spirometer, and all corresponding parameters in two groups were compared . Results:: (1) No difference of the corresponding parameters of baseline ventilation function in two groups was found. (2) The pulmonary ventilation function of patients in two groups was obviously improved after terbutaline inhaling (-P-<0. 01) , and the improvements of which in COPD patients were significantly lower than those in asthma patients (all -P-<0.01), and the improvements of which in simple form bronchitis patients were significantly lower than those in asthmatic form bronchitis patients (-P-<0.01 ). (3) Positive reaction in bronchodilatation test was found in 15.2 % COPD patients and 93.3 % asthmatic patients. Conclusion: The bronchial obstruction in patients with COPD is of certain reversibility which is lower than that in patients with asthma. β 2 -receptor excitant can result in significant effect on patients with COPD at high altitude.

关 键 词：慢性阻塞性肺疾病 哮喘 肺功能 支气管扩张试验 高原 

分 类 号：R563.9[医药卫生—呼吸系统] R562.25[医药卫生—内科学]