大体重成人支气管哮喘患者肺通气功能及气道反应性分析  

Analysis of pulmonary ventilation function and airway reactivity in large body weight adults with bronchial asthma

作　　者：裴硕 冉博文 樊芳芳[1] 张潍[1] 吕茹 胡晓芸[1] PEI Shuo;RAN Bo-wen;FAN Fang-fang;ZHANG Wei;L Ru;HU Xiao-yun(Department of Respiratory and Critical Care Medicine,the First Hospital of Shanxi Medical University,Taiyuan,Shanxi 030001,China)

机构地区：[1]山西医科大学第一医院呼吸与危重症医学科,山西太原030001

出　　处：《临床肺科杂志》2022年第5期691-695,700,共6页Journal of Clinical Pulmonary Medicine

摘　　要：目的探讨体重对成人哮喘患者肺通气功能与气道反应性的影响,了解大体重哮喘患者的肺功能特点。方法收集初诊哮喘患者620例,按BMI分为正常体重组(A组,BMI≤23.9 kg/m^(2))、超重组(B组,23.9 kg/m^(2)<BMI≤27.9 kg/m^(2))和肥胖组(C组,BMI>27.9 kg/m^(2)),各组再分为男、女亚组。对比不同组别及其亚组间肺通气功能及气道激发试验指标的差异,并分析BMI、性别与肺通气功能及气道激发试验指标的相关性。结果A、B及C组小气道功能障碍发生率分别为0.00%(0例)、0.72%(2例)和56.10%(69例)。B、C组FEF75%<A组,PEF>A组(P<0.05);A、B及C组各亚组FVC%pred女性>男性(P<0.05);B、C组各亚组FEF25%-75%女性<男性(P<0.05)。B、C组Rrs cont>A组,Grs cont<A组(P<0.05);B、C组各亚组Rrs con女性>男性,A、B及C组各亚组Grs cont、SGrs女性<男性(P<0.05)。男性BMI与Rrs cont呈正相关,与Grs cont呈负相关,女性BMI与PEF、Rrs cont呈正相关,与Grs cont、Dmin、SGrs呈负相关(P<0.05)。结论BMI升高可增加哮喘患者小气道功能障碍发生率及基础气道阻力,且对女性小气道功能、气道敏感性及气道阻力的影响更明显。Objective To investigate the effect of body weight on pulmonary ventilation function and airway reactivity in adult asthmatic patients,and to understand the characteristics of pulmonary function in overweight asthmatic patients.Methods A total of 620 newly diagnosed patients with asthma were collected and divided into normal-weight group(Group A,BMI≤23.9 kg/m^(2)),overweight group(Group B,23.9 kg/m^(2)<BMI≤27.9 kg/m^(2)),and obesity group(Group C,BMI>27.9 kg/m^(2))according to BMI.Each group was further divided into male and female subgroups.The differences in pulmonary ventilation function and airway stimulation test indexes between different groups and their subgroups were compared,and the correlations between BMI,gender and pulmonary ventilation function and airway stimulation test indexes were analyzed.Results The incidence of small airway dysfunction in groups A,B and C were 0.00%(0 cases),0.72%(2 cases),and 56.10%(69 cases),respectively.In both group B and C,the FEF75%was lower than group A,while the PEF was higher than group A(P<0.05).In each group,FVC%pred was greater in females than in males.But in groups B and C,FEF 25%-75%in females was less than males(P<0.05).Rrs cont in group B and C was larger than that in group A,while Grs cont was smaller than that in Group A(P<0.05).In each group,Rrs cont was greater in females than in males,Grs cont and SGrs were lower than in males(P<0.05).BMI in males was positively correlated with Rrs cont and negatively correlated with Grs cont,while BMI was positively correlated with PEF,Rrs cont,and negatively correlated with Grs cont,Dmin,and SGrs in females.Conclusion Elevated BMI can increase the incidence of small airway dysfunction and basic airway resistance in asthmatic patients and has a more obvious effect on female small airway function,airway sensitivity,and airway resistance.

关 键 词：肥胖 支气管哮喘 呼吸功能试验 支气管高反应性 

分 类 号：R562.25[医药卫生—呼吸系统]