146例支气管激发或舒张试验可疑阳性患者6个月随访肺功能转归调查  

Investigation of Pulmonary Function Outcomes of 146 Patients with Suspected Positive Results in Bronchial Provocation or Dilation Test after 6-month Follow-up

作　　者：谢涵 陈远彬 周明娟 林琳 吴蕾 XIE Han;CHEN Yuanbin;ZHOU Mingjuan;LIN Lin;WU Lei(Department of Pulmonary and Critical Care Medicine,the Second Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510120,China)

机构地区：[1]广州中医药大学第二附属医院呼吸与危重症医学科,广东省广州市510120

出　　处：《中国全科医学》2020年第10期1281-1286,共6页Chinese General Practice

基　　金：广东省科技计划项目(2016A020215187);国家中医药管理局中医临床研究基地业务建设科研专项(JDZX2015199);广东省中医药局专项(20171105)。

摘　　要：背景支气管哮喘是呼吸系统常见病,支气管激发或舒张试验阳性为诊断支气管哮喘的重要依据,但临床上常见支气管激发或舒张试验可疑阳性,且伴有临床症状的患者。目前尚缺乏分析此类患者预后转归结局影响因素的文献报道。目的 探讨支气管激发或舒张试验可疑阳性患者预后转归及其影响因素。方法 2015年8月-2018年2月,对320例支气管激发或舒张试验可疑阳性,并伴有咳嗽、咳痰、咽痒、喘息、气促、胸闷症状至少1项的患者,进行为期6个月随访,复查肺功能并记录症状、中医证候积分,统计患者的转归情况。随访前后临床症状占比、中医证候积分差异有统计学意义视为缓解,6个月后支气管激发或舒张试验可疑阳性转阴性视为好转。采用Logistic回归分析影响支气管激发或舒张试验可疑阳性患者转归的因素。结果 146例患者完成6个月的随访研究,其中49例支气管激发试验可疑阳性,97例支气管舒张试验可疑阳性。支气管激发试验可疑阳性6个月后转阴性者20例(40.8%),转阳性者2例(4.1%),可疑阳性者4例(8.2%),转支气管舒张试验者23例(46.9%);支气管舒张试验可疑阳性6个月后转阴性者44例(45.4%),转阳性者4例(4.1%),可疑阳性者10例(10.3%),转支气管激发试验者39例(40.2%)。随访6个月后,患者的中医证候积分降低(P<0.05)。患者主要症状(咳嗽、咳痰、咽痒、喘息、气促、胸闷)在6个月后都得到缓解,差异有统计学意义(P<0.05)。将随访前与随访6个月后均进行支气管激发试验或均进行支气管舒张试验的84例患者纳入分析,结果显示,不同年龄组支气管激发或舒张试验可疑阳性患者转归比较,差异有统计学意义(P<0.05);中药穴位贴敷治疗、无过敏性鼻炎、未使用吸入性糖皮质激素的患者,肺功能好转率更高(P<0.05)。Logistic回归分析结果显示,在多个因素同时作用的情况下,并无明显影响支气管�Background Bronchial asthma is a common disease of respiratory system,and positive results of bronchial provocation or dilation test are important evidence in the diagnosis of bronchial asthma.However,suspected positive bronchial provocation or dilation test results associated with symptoms are often observed in clinical practice.At present,there is no literature report on analyzing the influencing factors of the prognosis outcome of such patients.Objective To investigate the prognostic outcomes of patients with suspected positive results in bronchial provocation or dilation test and its influencing factors.Methods From August 2015 to February 2018,320 patients with suspected positive results in bronchial provocation or dilation test accompanied by at least one symptom of cough,expectoration,itching throat,wheezing,dyspnea and chest tightness were followed up for six months.The pulmonary function was reviewed and the symptoms and TCM syndrome scores were recorded to analyze the outcomes of the patients.Significant difference of clinical symptom proportion and TCM syndrome scores before and after follow-up was considered to be the remission of the disease.A transfer from suspected positive results to negative results in bronchial provocation or dilation test after six months was considered to be the improvement of the disease.Factors influencing the outcome of suspected positive patients with bronchial provocation or dilation test were analyzed by Logistic regression analysis.Results A total of 146 patients completed the 6-month followup,of which 49 patients were tested with suspected positive results in bronchial provocation test and 97 patients were tested with suspected positive results in bronchial dilation test.Among those 49 cases with suspected positive results in bronchial provocation test,20(40.8%) patients were tested with negative results;2(4.1%) patients were tested with positive results;4(8.2%) patients remained the same results,and 23(46.9%) patients underwent bronchial dilation test after six months

关 键 词：支气管激发试验 支气管舒张试验 可疑阳性 肺功能 预后 影响因素分析 

分 类 号：R562.25[医药卫生—呼吸系统]