不同肺功能检查方式在支气管哮喘指南中的诊断价值比较  

Comparison of Diagnostic Value in Different Pulmonary Function Tests in the Guidelines of Bronchial Asthma

作　　者：尹硕淼 陈远彬[2] 郑燕婵 杜庆湛 汤伟平 周明娟[2] 林琳[2] YIN Shuomiao;CHEN Yuanbin;ZHENG Yanchan;DU Qingzhan;TANG Weiping;ZHOU Mingjuan;LIN Lin(The Second Clinical Medical School of Guangzhou University of Chinese Medicine,Guangzhou 510006,China;Department of Respiration,Guangdong Hospital of Traditional Chinese Medicine,Guangzhou 510120,China)

机构地区：[1]广州中医药大学第二临床医学院,广东省广州市510006 [2]广东省中医院呼吸科,广东省广州市510120

出　　处：《中国全科医学》2018年第32期3911-3914,共4页Chinese General Practice

基　　金：国家自然科学基金面上项目(81373566;81573895);广东省科技计划资助项目(2016A020215187);2014年度广东省中医院中医临床评价研究专项立项课题(YN2014PJ02;YN2014WBR202)

摘　　要：通过分析《全球哮喘防治倡议》(GINA)及中国、日本、韩国、英国、印度及西班牙等国家发布的最新支气管哮喘防治指南中针对肺功能检查方式的论述,对常用的不同肺功能检查方式[如支气管舒张试验、支气管激发试验及呼气峰值流速(PEF)检测等]的重要性及临床价值等进行评估和分析,最终认为支气管哮喘指南所推荐的肺功能检查方式以支气管舒张试验及PEF检测为主,两者诊断价值较高,且接受度高,故应用较为普遍,尤其是两者的联合应用将更有利于支气管哮喘的诊断和评估;支气管激发试验也是诊断支气管哮喘的重要检查手段,但其操作风险较大,且特异度较差,应用存在一些争议,其诊断支气管哮喘的临床地位与价值不及支气管舒张试验及PEF检测。According to the discussion on the pulmonary function examination in Global Initiative for Asthma(GINA)and latest asthma prevention and treatment guidelines in China,Japan,South Korea,Britain,India and Spain,we evaluated and analyzed the clinical value and importance of different pulmonary function test modes〔such as bronchial dilation test,bronchial provocation test and peak expiratory flow(PEF)test〕.It was concluded that the pulmonary function tests recommended by bronchial asthma guidelines were bronchial dilation test and PEF test,which have high diagnostic value and high degree of acceptance,especially the combination of the two methods are more conducive to the diagnosis and evaluation of asthma.Because of high risk operation and lower specificity,there are some disputes about bronchial provocation test,another important test method,which has less value than bronchial dilation test and PEF test in clinical diagnosis of asthma.

关 键 词：哮喘 呼吸功能试验 支气管舒张试验 呼气峰值流速测试 支气管激发试验 诊断 指南 

分 类 号：R562.25[医药卫生—呼吸系统]