以心悸为主诉的支气管哮喘12例临床分析  

Atypical Asthma with Chief Complaint of Palpitations:Twelve Cases Analysis

作　　者：张景熙[1] 韩一平[1] 白冲[1] 李强[1] 

机构地区：[1]第二军医大学附属长海医院呼吸内科,上海200433

出　　处：《中国呼吸与危重监护杂志》2014年第2期112-115,共4页Chinese Journal of Respiratory and Critical Care Medicine

基　　金：国家自然科学基金(编号:81100017)

摘　　要：目的 探讨以心悸为主要表现的支气管哮喘（ 简称哮喘） 的临床特点与诊断要点。方法 12 例不明原因心悸患者通过支气管舒张试验、皮肤过敏原点刺试验、呼出气一氧化氮（ FeNO）等辅助检查综合判断, 通过诊断性治疗确立哮喘诊断并分析其临床特点。结果 12 例以心悸为主诉的哮喘患者中男2 例, 女10 例。误诊中位时间为13. 5 个月（ 3 ～120 个月） , 肺通气功能在正常范围,41. 6%尘螨皮肤点刺试验阳性, FeNO 中位值为32. 75 ppb（ 18 ～54 ppb） , 经辅助检查、诊断性治疗并排除其他疾病, 诊断为哮喘, 经规范治疗后所有患者心悸症状均完全缓解。结论 心悸是以嗜酸细胞性气道炎症为特征的哮喘的一种特殊临床表现, 以心悸为主诉的哮喘在临床上易被误诊, 多见于中老年女性, 临床上应提高对这一非典型哮喘的认识, 详细询问病史、开展相应辅助检查、诊断性治疗是有效提高其诊断率的关键措施。Objective To explore the clinical features of atypical bronchial asthma with chief complaint of palpitations. Methods Twelve cases with unexplained palpitations diagnosed by asthma were analyzed retrospectively.Results The patients were diagnosed with asthma through bronchodilation test,skin prick tests, fractional exhaled nitric oxide （ FeNO） and diagnostic treatment. The ratio of male to female cases was 1 ∶5. The ventilation lung function of all patients was in normal range. The median time of misdiagnosis was 13. 5（ 3-120） months. 41. 6% of cases had dustmite positive skin prick test. The median value of FeNO was 32. 75（ 18-54） ppb. The symptoms of all patients were relieved completely after standard treatment. Conclusions Palpatation may be a specific presentation of asthma characterized with eosinophilic airway inflammation which may be misdiagnosed as other diseases for a long time, especially in elder women. To improve the knowledge of this kind of atypical asthma, detailed medical history,experimental examinations and diagnostic treatment response are important to confirm the diagnosis in time.

关 键 词：哮喘 心悸 诊断 呼出气一氧化氮 肺功能 

分 类 号：R562.25[医药卫生—呼吸系统]