COPD和哮喘患者吸入支气管扩张剂后EFL、FEV_1及IC的变化  

Changes of EFL, FEV_1 and IC in Patients with Chronice Obstructive Pulomonary Disease and Asthma after Inhaling Bronchodilators

作　　者：秦慧[1] 李燕芹[1] 赵旭霁[1] 查琼芳[1] 刘斌[1] 邹静[1] 陈燕[1] 

机构地区：[1]上海交通大学医学院仁济医院呼吸科,上海200127

出　　处：《上海交通大学学报（医学版）》2006年第8期916-918,共3页Journal of Shanghai Jiao tong University:Medical Science

摘　　要：目的观察慢性阻塞性肺疾病(COPD)和哮喘患者在吸入支气管扩张剂后1s用力呼气容积(FEV1)、深吸气量(IC)和呼气流速受限(EFL)的变化。方法33名急性发作的COPD患者和哮喘13名患者通过定量气雾剂吸入400μg沙丁胺醇,并于吸药前和吸药后20min分别检测常规肺功能,并应用呼气负压(NEP)技术检测EFL。结果33例COPD患者吸药前坐卧位均存在EFL,在吸入支气管扩张剂后仅1例坐位时EFL消失,其余32例坐卧位均仍存在EFL;13例哮喘患者吸药前坐位和(或)卧位均存在EFL,吸药后10例坐卧位EFL均消失,3例坐位EFL消失而卧位存在。26名COPD患者吸入支气管扩张剂后显示了IC明显的增加(△IC>15%)。结论对于COPD患者,评价支气管扩张剂的疗效时,IC较FEV1、EFL的变化更加敏感;而哮喘患者EFL的变化能较好地反映出患者对支气管扩张剂的疗效。Objective To analyze the change of forced expiratory volume in one second （FEV1） , inspiratory capacity （IC） and expiratory flow limitation （EFL） in patients with chronic obstructive pulmonary disease （COPD） and asthma. Methods In 33 COPD patients and 13 asthma patients, pulmonary function tests and a series of expiratory negative pressure （NEP） （ -5 cmH2O） breath tests were performed at rest in seated and supine position before and 20 min after inhaling of 400 μg of salbutamol. EFL was assessed by applying NEP at the mouth during tidal expiration. Results EFL existed in 33 COPD patients in both positions and persisted after using salbutamol in 32 of them. Only one patients with COPD who was flow-limited in both positions was flow-limited only in supine position after inhaling bronchodilator. Thirteen patients with asthma were flow-limited in seated and/or supine position before salbutamol inhalation, among whom 10 were not flow-limited, and 3 were flow-limited only in supine position after salbutamol inhalation. Twenty-six patients with COPD exhibited a significant increase in inspiratory capacity （IC） after salbutamol inhalatin. Conclusion The change of IC is more sensitive than FEV1 or EFL in assessing the effect of bronchodilator for COPD, while the change of EFL is a better parameter for asthma.

关 键 词：慢性阻塞性肺疾病 哮喘 呼气负压技术 呼气流速受限 1 s用力呼气容积 深吸气量 

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