小气道功能对咳嗽变异型哮喘患者的诊断价值探讨  

Small airway Function's diagnostic value on patients with cough variant asthma

作　　者：赵珊[1] 王浩彦[2] 李宾[2] 赵旭娟[2] 杨小丽[2] 

机构地区：[1]北京市房山区良乡医院,北京102401 [2]首都医科大学附属北京友谊医院,北京100050

出　　处：《基层医学论坛》2015年第13期1731-1734,共4页The Medical Forum

摘　　要：目的探讨小气道功能异常对咳嗽变异型哮喘患者的诊断价值。方法入组100例慢性咳嗽患者进行支气管激发试验,按随访结果分为咳嗽变异型哮喘(CVA)组与非CVA组,比较2组患者激发前基础状态下及激发结束时的肺通气功能,小气道功能异常的发生率及小气道功能的变化率,分析各参数变化率的敏感度及特异度。结果 2组激发后与激发前基础状态相比FVC、FVC%、FEV1、FEV1%、FEV1/FVC%、FEF25、FEF25%、FEF50、FEF50%、FEF75、FEF75%、MMEF、MMEF%均有明显下降(P<0.05),激发前及激发后CVA组的各项参数较非CVA组均有明显下降,差异有统计学意义。CVA组FEF25%、FEF50%、FEF75%、MMEF%较非CVA组均有明显下降,差异有统计学意义。CVA组小气道异常率明显高于阴性组(P<0.01)。CVA组FEF25、FEF50、FEF75、MMEF变化率高于非CVA组(P<0.05)。曲线下面积结果提示:FEV1变化率>FEF25变化率>FEF50变化率>FEV1变化量>MMEF变化率>FEF75变化率。结论在激发前基础状态下及激发后,CVA患者大小气道功能均低于非CVA患者,FEF50变化率对CVA诊断的敏感度最高,重视小气道功能异常能协助临床早期发现CVA。Objective Discuss the small airway function＇s dagnostic？value on patients with cough variant asthma. Method Select out 100 patients with chronic cough to do Bronchial provocation test （BPT）, divide these patients into two groups, cough variant asthma （CAV） group and non-cough variant asthma group according to the follow-up result. Compare CAV group and non-CAV group＇s pulmonary ventilation？function before BPT and after BPT. Compare the incidence of abnormal function of small airway and the change rate of small airway function. Analyze the sensitivity and specific degrees of the variation of the parameters. Result Compared with base state, the parameters of FVC, FVC% , FEV1, FEV1% , FEVJFVC% , FEF25, FEF25% , FEFS0,FEFS0% ,FEF75, FEF75% , MMEF,MMEF% after BPT have a dramatic decline. Before and after BPT, compared with non-CVA group, the CVA group all have a dramatic decline on these parameters and the differences are statistical significant. The abnormality rate of small airway of CVA group is apparently higher than non-CVAgroup （P〈O.O1）. The change rate of FEF25,FEF50,FEF75,MMEF of CVA group is higher than non-CAV group. （P〈0.05）. Observe the area under curve （AUC）, the result is FEV~ change rate〉FEF25 change rate〉FEF50 change rate〉FEVlvariation〉MMEF change rate 〉FEF75 change rate.Conclusion Before and after BPT, both CVA patients＇ main and small airway function is lower than non-CAV patients. FEFSO change rate possess the highest sensitivity to CVA diagnosis. Pay attention to the abnormality rate of small airway function＇s clinical help on CVA＇s early detection.

关 键 词：咳嗽变异型哮喘 诊断 支气管激发试验 小气道功能 

分 类 号：R562.25[医药卫生—呼吸系统]