支气管激发试验前后小气道功能测定对慢性咳嗽病因诊断的价值  

Etiological diagnosis utilization value of bronchial provocation test in patients with chronic cough

作　　者：李建华[1] 季云瑞 张力燕[1] 方雁[1] 业秀林[1] 

机构地区：[1]昆明医科大学第一附属医院呼吸内科,650032 [2]昆明医科大学,650500

出　　处：《国际呼吸杂志》2015年第5期333-335,共3页International Journal of Respiration

摘　　要：目的探讨慢性咳嗽患者支气管激发试验前后小气道功能、气道阻力及胸外气道反应的状况。方法68例慢性咳嗽患者进行组胺支气管激发试验，观察FEV，、呼气中期流速（MEF50）及吸气中期流速（MIF50）的变化，并应用脉冲振荡技术测定激发前后患者气道阻力。结果支气管激发试验阳性率52％，激发阳性患者激发前MEF50，Ro与阴性组患者差异有统计学意义。MEFso激发后／激发前比值（MEF50％）与FEV，激发后／激发前比值（FEV，％）星正相关，与R0激发前后差值（Rw）呈负相关。13例患者呈现胸外气道高反应（占总例数20％），其中6例为单独存在胸外气道高反应，7例患者合并支气管气道高反应。结论观察慢性咳嗽患者小气道功能变化，有利于对哮喘的及早诊治，有利于遏制小气道不可逆损害发展为COPD的危险。激发试验时联合观察支气管气道反应和胸外气道反应，可为临床诊断提供线索。Objective To study the bronchial provocation tests before and after the small airway function in patients with chronic cough, airway resistance, and the status of the extrathoracic airway reaction. Methods Sixty-eight patients with chronic cough were histamine bronchial provocation tests, observation FEV1, mid expiratory flow rate （MEF0） the change of the mid and suction flow rate （MIF50）, and applies the patients before and after the forced oscillation technique determination inspire airway resistance. Results Bronchial provocation tests positive rate 52%,arouse positive patients before MEF50 ,R0 patients with negative group difference was statistically significant. MEF50 excitation after/ before ratio （MEF50%） and FEVI, stimulate after/before ratio （FEV1%） were positively correlated, and R0 stimulates the difference before and after the negative correlation （R0-d）. Thirteen patients present external chest high reaction （accounts for 20% of total cases） , among them 6 cases to exist alone external chest high response,7 cases of patients with airway hyperresponsiveness bronchial merger. Conclusions To observe change of small airway function in patients with chronic cough, is helpful to early diagnosis and treatment of asthma. Proocation tests joint observation of bronchial airway responses and extrathoracic airway reaction,can provide clues for clinical diagnosis.

关 键 词：慢性咳嗽 支气管激发试验 小气道功能 胸外气道高反应 

分 类 号：R56[医药卫生—呼吸系统]