哮喘支气管舒张试验的新技术研究  

Study of new technology in the measurement of bronchodilator responsiveness

作　　者：刘锦铭[1] 胡华成[1] 施敏华[1] 邱洁萍 杨文兰 郑卫 

机构地区：[1]苏州大学第二附属医院,江苏苏州215004 [2]同济大学附属上海市肺科医院

出　　处：《山东医药》2008年第1期36-38,共3页Shandong Medical Journal

基　　金：上海市科学技术发展基金项目(034119867)。

摘　　要：目的以肺通气功能进行支气管舒张试验的方法作为"金标准",探讨脉冲振荡法(IOS)参数在支气管舒张试验中的灵敏度、特异度及阳性标准。方法对37例急性发作期哮喘患者和30例健康者进行支气管舒张试验,吸药前后均先行IOS测定,再行肺通气功能测定。结果哮喘组支气管舒张试验阳性率为83.8%,对照组为10%。哮喘组第1秒用力呼气容积(FEV1)、最大用力呼气峰流量(PEF)及IOS各参数舒张后值和基础值之间均有统计学差异(P<0.01)。所有受试者中FEV1均与PEF、IOS各参数呈显著直线相关(除对照组舒张后R5-R20外)。结论IOS可作为支气管舒张试验可选择的肺功能方法之一,以Z5下降≥37.7%、R5下降≥37.9%作为支气管舒张试验的阳性标准较合理。Objective To investigate the sensitivity and specificity and diagnostic criteria of impulse oscillometry （IOS） parameters in the measurement of bronchodilator responsiveness, and compare with the routine splrometry method which acts as a ＂gold standard＂. Methods 37 outpatients during asthma attack were selected randomly to perform bronchodilator reversibility test with IOS and spirometry respectively, so did 30 heathy controls. IOS and spirometry were measured before and after inhalation of bronchodilator. Results Positive rate of bronchodilator responsiveness was 83.8% in the asthma group, but it was 10% in the control group. FEV1, PEF and all parameters of IOS were significantly changed between the postbonchodilator value and the basic value in asthma group （P 〈0. 01 ）. OF all subjects, FEV1 was significantly correlated with PEF and IOS parameters （except for posthonchodilator value of R5 - R20 in control group） in the baseline value and the posthonchodilator value （P 〈 0. 05）. Conclusions Impulse osciUometry is an alternative method for bronchodilator reversibility test. When decrease of Z5 is equal to or more than 37.7% and decrease of R5 is 37.9% or more after inhalation of. bronchodilator, the bronchial reversibility test is considered as positive.

关 键 词：肺功能 脉冲振荡法 哮喘 支气管舒张试验 

分 类 号：R562.2[医药卫生—呼吸系统]