慢性阻塞性肺疾病合并支气管舒张试验阳性的临床研究  

Clinical analysis of COPD cases with positive bronchial dilation test

作　　者：李世川[1,2] 张湘燕[2] 廖强[2] 张程[1,2] 

机构地区：[1]贵阳医学院,贵州贵阳550004 [2]贵州省人民医院呼吸科,贵州贵阳550002

出　　处：《贵州医药》2015年第5期385-387,共3页Guizhou Medical Journal

基　　金：十二五国家科技支撑计划(2013BAI09B09);科技部国家科技支撑计划(2013BAI05B03);国家科技支撑计划(2013BAI06B00)

摘　　要：目的对慢性阻塞性肺疾病(COPD)合并支气管舒张试验阳性患者的主要辅助检查进行分析,为该病的诊治提供临床资料。方法 2013年4-12月选取60例COPD患者为研究对象,其中支气管舒张试验阳性者30例为研究组,阴性者30例为对照组。分析两组药前及药后1s用力呼气容积占预计值百分比(FEV 1%pred)、1s用力呼气容积与用力肺活量的比值(FEV 1/FVC)、二氧化碳分压(PaCO2)、氧分压(PaO2)及血常规等相关结果的差异。结果研究组药前FEV 1%pred、FEV1/FVC%较对照组降低;但药后该指标较对照组升高,差异均有统计学意义(P<0.05);血常规检查示:嗜酸性粒细胞计数较对照组升高,差异亦有统计学意义(P<0.01);而血气分析指标PaO2、PaCO2以及外周血血红蛋白计数与对照组比较,差异均无统计学意义(P>0.05)。结论嗜酸粒细胞浸润可能是COPD出现气道高反应性的重要原因;该类患者气道阻塞程度在未有效治疗前可能较无气道高反应性的患者更重;但在支气管扩张剂治疗后其阻塞程度明显改善,易于逆转,因此应该进一步加强治疗。Objective To analyze the important parameters of clinical assistant examination for patients with COPD and positive bronchial dilation test ,aimed at providing some essential clinical data or information for the re‐lated‐disease diagnosis and treatment .Method 60 stable COPD patients were selected from April 2013 to December 2013 ,among which 30 cases with positive bronchial dilation test were randomly selected as the study group ,while other 30 ones with negative bronchial dilation test as the control group .Some parameters were analyzed such as the forced expiratory volume percent predicted （FEV1% pred） ,partial pressure of carbon dioxide （PaCO2 ） ,partial pressure of oxygen （PaO2 ） ,routine blood test and so on .Result The ratios of FEV1% pred and FEV1/FVC% were lower in study group than in control group before inhalation of bronchodilator ,while they turned higher in study group after inhalation of the drug （all P〈0 .05 ） .Eosinophilic cell counts in peripheral blood were higher in study group than the control group ,but no differences found in PaO2 ,PaCO2 and hemoglobin levels between the two groups （all P〈0 .05） .Conclusion The infiltration of eosinophils may be involved in airway hyperresponsiveness in COPD cases .Patients with airway hyperresponsiveness may have more severe airway obstruction than those without airway hyperresponsiveness .But after inhalation of bronchodilator ,this kind of obstruction may be improved more in the former than in the latter ,which should be paid more attentions in clinic .

关 键 词：慢性阻塞性肺疾病 支气管扩张试验 临床分析 

分 类 号：R562.2[医药卫生—呼吸系统]