17例以心悸为主要症状的支气管哮喘临床分析  

Clinical Analysis of 17 cases of Bronchial Asthma with Palpitation as the Main Symptom

作　　者：汪新龙[1] 刘朝晖[2] 丁巍[1] 范伟[2] 梁志科[2] 

机构地区：[1]广州市第一人民医院南沙医院,广东广州511457 [2]广州医科大学附属广州市第一人民医院

出　　处：《中国医学创新》2017年第3期122-125,共4页Medical Innovation of China

摘　　要：目的:探讨以心悸为主要症状的支气管哮喘的临床特征,认识其诊治要点并减少漏诊、误诊。方法:回顾性分析17例以心悸为主要症状的支气管哮喘的病历,就其相关临床资料进行归纳统计。结果:17例患者经肺功能检查、支气管激发试验等检查及诊断性治疗确诊为支气管哮喘。肺功能检测肺通气相关指标显示,激发前的肺功能指标中的PEF_(25)、PEF_(50)、PEF_(75)、MMEF_(75/25)异常率分别为11.8%、5.9%、29.4%、17.6%,其余指标均正常。17例患者支气管激发试验均阳性,激发后肺通气指标均明显低于激发前指标,差异均有统计学意义(P<0.05)。所有患者经规范治疗后症状明显好转,1~2个月症状完全缓解,继续用药并随访3个月,病情无反复。结论:心悸是支气管哮喘的一种较少见的临床表现,多见于女性。由于缺乏特异性症状在临床上容易被误诊漏诊,临床工作中遇到主要症状为心悸的患者,应仔细询问病史,详细进行各项检查如肺功能检测及支气管激发试验,减少漏诊和误诊,确诊后吸入舒利迭(沙美特罗/丙酸氟替卡松)为有效治疗方法。Objective：To explore the clinical features of bronchial asthma with the main symptoms of heart palpitations,to recognize the main points of diagnosis and treatment,and to reduce missed diagnosis and misdiagnosis.Method：The clinical data of 17 bronchial asthma patients with main symptoms of heart palpitations,were analyzed retrospectively.Result：17 patients were diagnosed as bronchial asthma by pulmonary function test,bronchial provocation test and diagnostic treatment.Pulmonary function tests showed that pulmonary ventilation related indicators,the abnormal rates of PEF25,PEF50,PEF75,and MMEF75/25 were 11.8%,5.9%,29.4% and 17.6%,respectively,the other indicators were normal.Bronchial provocation test was positive in 17 patients,the indexes of pulmonary ventilation were significantly lower than those of pre-excitation,the differences werestatistically significant（P〈0.05）.After treatment,all the patients were significantly improved,and the symptoms were completely relieved after 1 to 2 months,the patients were followed up for 3 months.Conclusion：Palpitation is a rare clinical manifestation of bronchial asthma which is more common in women.Due to the lack of specific clinical symptoms,the rate of misdiagnosis and missed diagnosis is high.Patients with the main symptoms of palpitation should be asked in detail about the history and carried out inspection such as pulmonary function testing and bronchial provocation test,to reduce the misdiagnosis and missed diagnosis rate.Inhaled Seretide（Salmeterol/Propionic Acid Fluoride Fluticasone Propionate） is an effective treatment method after diagnosed.

关 键 词：支气管哮喘 心悸 临床诊治 临床分析 

分 类 号：R562.25[医药卫生—呼吸系统]