不同程度慢性阻塞性肺疾病患者支气管舒张试验前后肺功能各参数改善的比较  

Comparison of Pulmonary Function Parameters in Patients with Different Degrees of Chronic Obstructive Pulmonary Disease before and after Bronchial Dilation Test

作　　者：魏兵[1] 周玉涛[1] 陈玉[1] 高赏[1] 任魁[1] 聂秀红[1] 

机构地区：[1]首都医科大学宣武医院呼吸科,北京100053

出　　处：《医学综述》2017年第6期1219-1223,共5页Medical Recapitulate

摘　　要：目的探讨支气管舒张试验对不同程度慢性阻塞性肺疾病(COPD)患者肺功能各参数改善的影响。方法选取2012年11月至2014年5月于首都医科大学宣武医院门诊就诊的COPD稳定期患者163例,按2011版慢性阻塞性肺疾病全球倡议(GOLD)策略将患者分为低风险少症状组67例、低风险多症状组34例、高风险少症状组24例、高风险多症状组38例。所有患者行支气管舒张试验,试验前后分别检查肺功能。其中肺功能分别测定肺通气功能用力肺活量(FVC)、第1秒用力呼气量(FEV_1)、FEV_1/FVC及呼气峰值流速(PEF)。计算舒张试验前后肺功能参数FEV_1/FVC、FEV_1占预计值百分比(FEV_1%pred)、PEF的改善值。结果低风险少症状组、低风险多症状组、高风险少症状组、高风险多症状组FEV_1/FVC改善值为(1.83±1.02)%、(2.80±0.99)%、(1.69±0.59)%、(1.06±0.18)%,FEV_1%pred改善值为(1.72±0.56)L、(2.49±1.02)L、(1.39±0.30)L、(1.08±0.24)L,PEF改善值为(0.26±0.08)L/s、(0.42±0.31)L/s、(0.27±0.12)L/s、(0.16±0.09)L/s,四组FEV_1/FVC改善值、FEV_1%pred改善值、PEF改善值比较差异有统计学意义(P<0.05)。低风险多症状组FEV_1/FVC改善值、FEV_1%pred改善值、PEF改善值与低风险少症状组比较差异无统计学意义(P>0.05)。高风险少症状组FEV_1/FVC改善值、FEV_1%pred改善值明显低于低风险少症状组、低风险多症状组(P<0.05),PEF改善值与低风险少症状组、低风险多症状组比较差异无统计学意义(P>0.05)。高风险多症状组FEV_1/FVC(%)改善值、FEV_1%pred(L)改善值明显其他三组(P<0.05),PEF改善值明显低于低风险少症状组、低风险多症状组(P<0.05),PEF改善值与高风险少症状组比较差异无统计学意义(P>0.05)。结论支气管扩张剂对各组COPD患者气道均有不同程度的扩张作用,COPD患者应加强应用支气管扩张剂。Objective To investigate the effects of bronchial dilation test on the parameters of pulmonary function in patients with chronic obstructive pulmonary disease（COPD）. Methods From Nov. 2012 to May 2014,163 patients with COPD stable stage were selected from the outpatient clinic of Capital Medical University Xuanwu Hospital. In accordance with the 2011 version of the GOLD strategy,the patients were divided into a low-risk and less-symptom group of 67 cases,a low-risk multi-symptom group of 34 cases,a high-risk less-symptom group of 24 cases,and a high-risk multi-symptom group of 38 cases. All patients underwent bronchial dilation test,and routine pulmonary function were examined before and after the test. The routine pulmonary function were measured by forced vital capacity（FVC）,forced expiratory volume in one second（FEV1）,FEV1/FVC and peak expiratory flow（PEF）. The improvement of pulmonary function parameters FEV1/FVC,percentage of predicted value（FEV1% pred） and PEF before and after diastolic test were calculated. Results FEV1/FVC improvement value in low-risk less-symptom group and low-risk multi-symptom,high-risky less-symptom,highrisk multi-symptom group were（1. 83 ± 1. 02） %,（2. 80 ± 0. 99） %,（1. 69 ± 0. 59） %,（1. 06 ± 0. 18） % respectively,FEV1% pred improvement value were（1. 72 ± 0. 56） L,（2. 49 ± 1. 02） L,（1. 39 ± 0. 30） L,（1. 08 ± 0. 24） L,PEF improved value were（0. 26 ± 0. 08） L/s,（0. 42 ± 0. 31） L/s,（0. 27 ± 0. 12） L/s,（0. 16 ± 0. 09） L/s,and FEV1/FVC improvement value,FEV1% Pred improvement,PEF improvement value of the four groups had statistically significant differences（P 〈 0. 05）. There was no significant difference in FEV1/FVC improvement,FEV1% pred improvement and PEF improvement between the low-risk less-symptom group and low-risk multi-symptom group（P 〉 0. 05）. The improvement of FEV1/FVC and FEV1% pred of the high-risk less-symptom group were significantly lower than those of the low-risk lesssymptom gro

关 键 词：慢性阻塞性肺疾病 支气管舒张试验 肺功能 

分 类 号：R320.24[医药卫生—人体解剖和组织胚胎学]