Astograph法支气管激发试验在诊断哮喘的作用研究  

Role of astograph methacholine provocation test in diagnosis of bronchial asthma

作　　者：杨宏宽 张佳颖 王芳 陈芳[2] 

机构地区：[1]浙江中医药大学第一临床医学院,杭州市310053 [2]浙江中医药大学附属第一医院肺功能室,杭州市310000

出　　处：《实用医学杂志》2017年第22期3807-3809,共3页The Journal of Practical Medicine

基　　金：国家自然科学基金青年项目(编号:81302934);浙江中医药大学研究生教育教学改革项目(编号:721100G00836);浙江中医药大学校级课题(编号:2014ZY14)

摘　　要：目的评价Astograph法支气管激发试验在诊断支气管哮喘的应用价值。方法选择238例哮喘患者及489例非哮喘患者,完成Astograph法乙酰甲胆碱支气管激发试验,统计分析各指标的差异,寻找具有诊断意义的指标及临界值。结果两组Rrs cont、Grs cont均未见明显差异。与非哮喘组比较,哮喘组Dmin、Cmin、PD15均减小(P<0.01),SGrs、SGrs/Grs cont均增大(P<0.01)。哮喘组SGrs与Dmin、Cmin、PD15相关(P=0.000;r=0.685,r=0.657,r=0.639),SGrs/Grs cont与Dmin、Cmin、PD15相关(P=0.000,r=0.775;r=0.740;r=0.708)。以Dmin诊断哮喘,临界值2.71Unit,敏感性0.739,特异性0.551。以PD15诊断哮喘,临界值4.8565 Unit,敏感性0.693,特异性0.684。结论 Astograph法支气管激发试验对诊断哮喘具有重要作用,其中以Dmin≤2.71 Unit或PD15≤4.8565 Unit为阳性标准,对诊断哮喘有较好的敏感性及特异性。Objective To evaluate the diagnostic value of astograph methaeholine provocation test for bronchial asthma. Methods A total of 238 asthma patients and 499 non-asthma patients participated in the detection by astograph methacho]ine provocation test. Statistical methods were used to ana]yze the differences of astograph parameters and find the indicators of asthma diagnosis and the critical value. Results Dmin, Cmin and PD15 were much lower in the asthma group （P 〈 0.01） , compared with the the non-asthma group, when SGrs, SGrs/Grs cont were much higher （P 〈 0.01 ）. SGrs was relevant with Dmin, Cmin, PD15 in the asthma group （P = 0.000; r = 0.685, r = 0.657, r = 0.639） as well as the SGrs/Grs cont did （P = 0.000, r = 0.775; r = 0.740, r = 0.708）. In ROC analysis, Dmin presented an AUC of 0.661, the cutoff value was 2.71 unit, with a sensitivity of 0.739 and specificity of 0.551. PD15 presented an AUC of 0.746, the cutoff value was 4.856 5 unit, with a sensitivity of 0.693 and specificity of 0.684. Conclusion Astograph methacholine provocation test shows good sensitivity and specificity in the diagnosis of asthma, particularly when Dmin ≤2.71 Unit or PD15 ≤ 4.8565 Unit as the cutoff value.

关 键 词：哮喘 Astograph法 支气管激发试验 气道高反应性 诊断 

分 类 号：R562.25[医药卫生—呼吸系统]