最大通气量测定前后气道阻力变化对咳嗽变异型哮喘的诊断价值探讨  

Diagnostic value of airway resistance changes before and after maximal voluntary ventilation for patients with cough variant asthma

作　　者：王廷杰[1] 王平飞[1] 王家驷[1] 张雪漫 冉梅[1] 

机构地区：[1]达州市中心医院呼吸内科,四川达州635000

出　　处：《中国呼吸与危重监护杂志》2007年第4期249-252,共4页Chinese Journal of Respiratory and Critical Care Medicine

基　　金：四川省卫生厅科研基金资助(编号:020105)

摘　　要：目的探讨最大通气量(MVV)测定前后气道阻力变化对咳嗽变异型哮喘(CVA)的诊断价值。方法前瞻性对比观察36例原因不明拟诊CVA的慢性咳嗽患者MVV测定前后气道阻力变化与支气管激发试验(BPT,25例)或舒张试验(11例)结果的一致性。用脉冲振荡法(IOS)测定气道阻力,MVV测定前后气道阻力显著升高以ZRS、R5升高20%和/或R20升高15%为阳性标准。结果15例BPT阳性患者中,14例MVV测定前后气道阻力变化显著;另10例BPT阴性患者者中9例MVV测定前后气道阻力变化不显著,二者的符合率达92%[(14+9)/25]。11例行支气管舒张试验的患者试验结果全为阳性,且MVV测定前后气道阻力均显著升高,二者符合率达100%。提示最大通气量测试前后气道阻力的变化符合哮喘患者气道反应性的变化,总符合率94.4%[(14+9+11)/36]。结论MVV检测前后气道阻力的变化可反映气道反应性,有望成为诊断CVA的简便、安全的新方法。Objective To explore the diagnostic value of airway resistance changes before and after maximal voluntary ventilation （MVV） measurement for patients with cough variant asthma （CVA）. Methods Thirty-six patients suffered from chronic cough for 3 months to 15 years were enrolled in the study. Changes of airway resistance before and after performing MVV were measured and compared with the results of bronchial provocation test（BPT） or bronchodilation test. The airway resistance was measured by impulse oscillometry and the changes of ZRS and R5 above 20% or R20 above 15 % were judged as positive. Results 14 subjects showed significant changes of airway resistance before and after MVV in 15 subjects with BPT positive and 9 subjects showed no significant changes of airway resistance in 10 subjects with BPT negative. All 11 patients underwent bronchodilation test yielded positive result, meanwhile airway resistance showed significant changes. Total consistency ratio was 94.4% [ （14 ＋ 9 ＋ 11）/36]. Conclusion The airway responsiveness can he well reflected by airway resistance changes before and after MVV which may he a new convenient and more safe approach for diagnosis of CVA.

关 键 词：咳嗽变异型哮喘 气道阻力 脉冲振荡法 肺功能 支气管激发试验 

分 类 号：R562.25[医药卫生—呼吸系统]