支气管扩张试验后哮喘患者痉挛气道的解痉时相研究  

Changes of spasmolysant airways in different phrases in asthmatic patients after bronchodilation test

作　　者：魏剑琴[1] 董泽华[2] 黄瑾[3] 荆伟丽[2] 尹金植[1] 辛秀芹[1] 

机构地区：[1]吉林大学第二医院呼吸内科,吉林长春130041 [2]青岛大学医学院附属医院ICU科,山东青岛266003 [3]中山大学附属第五医院呼吸内科,广东珠海519000

出　　处：《吉林大学学报（医学版）》2006年第3期493-495,510,共4页Journal of Jilin University：Medicine Edition

基　　金：国家自然科学基金资助课题(30070329)

摘　　要：目的:研究哮喘患者痉挛气道的解痉时相线性规律,为哮喘患者的解痉治疗提供理论依据。方法:16例哮喘发作期患者和14例志愿者进行支气管扩张试验,雾化吸入沙丁胺醇后15 min、30 min、1 h、2 h及4 h各个时间点,分别记录FVC、FEV1、PEF反映大气道功能,以及MMEF、V50、V25反映小气道功能。以志愿者为对照,观察哮喘患者大、小气道解痉时相的差异。建立哮喘患者肺功能指标拟合直线方程,比较拟合直线方程斜率,对哮喘患者大、小气道解痉时相对比分析。结果:在2 h时哮喘患者痉挛的大气道已经达到完全解痉,FVC、FEV1、PEF与对照组比较差异无显著性。小气道解痉的时间明显滞后,在观察期内各个时间点,除V50外,哮喘患者的MMEF、V25与对照组比较差异有显著性(P<0.05)。FVC、FEV1、PEF随时间变化曲线图的拟合直线方程斜率小于0的所占百分比较低;而MMEF、V50、V25所占百分比较高(P<0.05)。结论:哮喘患者痉挛的大、小气道解痉时相不同,大气道先解痉,而小气道解痉延迟。临床可针对大气道痉挛为主的患者选用长效或短效药物,而小气道痉挛为主的患者适于选择长效药物。Objective To explore the linearic regularity of airways＇ spasm and spasmolysis in asthmatic patients, and provide theory bases for clinic treatment. Methods After regular bronchodilation test, the pulmonary function in 16 asthmatic patients and 14 volunteers were examined 15 min, 30 min, 1 h, 2 h and 4 h later, respectively. The indexes included forced vital capacity （FVC）, forced expiratory flow in one second （FEV1）, peak expiratory flow （PEF）, maximal midexpiratory flow （MMEF）, expiration of 50% FVC （V50） and expiration of 75% FVC （V25） . Results 2 h after bronchodilation test, the big airways dilated completely （P〈0.05）, while the small airways dilated much later and incomplete except V50. The percentage of indexes including FVC, FEV1, PEF whose slopes of model straight line were negative was lower. But it was higher to indexes including MMEF, V50 and V25 （P〈0.05）. Conclusion The big airways dilate first and small ones later after given salbutamol. It is helpful for big airways spasm patients to choose the long-acting drugs or short-acting drugs, and for small airways spasm patients the long-acting drugs should be chosen.

关 键 词：哮喘 支气管高反应性 支气管扩张试验 

分 类 号：R562.25[医药卫生—呼吸系统]