行气道激发试验检查哮喘及非哮喘患者临床分析  

Clinical analysis of asthmatic and non-asthmatic patients examined by routine bronchial provocation test

作　　者：焦风伟[1] 侯安纳 张黎明[1] JIAO Feng-wei;HOU An-na;ZHANG Li-ming(Department of Respiratory and Critical Care Medicine,Beijing Institute of Respiratory Medicine and Beijing Chaoyang Hospital,Capital Medical University,Beijing 100020,China)

机构地区：[1]首都医科大学附属北京朝阳医院-北京市呼吸疾病研究所,呼吸与危重症医学科,北京100020

出　　处：《临床肺科杂志》2022年第10期1509-1513,共5页Journal of Clinical Pulmonary Medicine

摘　　要：目的探讨气道激发试验患者中哮喘与非哮喘患者小气道功能、大气道功能、气道炎症的差别及其在哮喘诊断中的意义。方法纳入门诊行气道激发试验及肺通气功能检查的患者,分为哮喘组及非哮喘组。收集临床资料及激发试验、肺功能、呼出气一氧化氮(FeNO)、血常规、血清IgE结果。比较不同组间的差异,分析影响哮喘诊断的危险因素。结果共304例患者入选,哮喘组(217例)与非哮喘组(87例)在喘息、FeNO、小气道功能障碍发生率、FEV_(1)、FEV_(1)/FVC、嗜酸性粒细胞计数大于300个/μL的患者比率等方面差别存在显著性(P<0.05);哮喘组患者FeNO与嗜酸性粒细胞计数,存在中度相关(r=0.477),相关性高于非哮喘组(r=0.272)。二元Logistic回归分析显示FeNO与小气道功能障碍是哮喘诊断的独立危险因素,二者联合诊断哮喘的敏感度性为38.9%,特异性87.9%。结论哮喘患者FeNO与外周血嗜酸性粒细胞计数存在中度相关;FeNO和小气道功能障碍可用于哮喘的辅助诊断。Objective To investigate the differences of small airway function,large airway function and airway inflammation in asthmatic and non-asthmatic patients with bronchial provocation test(BPT)and its value in the diagnosis of asthma.Methods Patients who performed BPT and pulmonary ventilation function test were divided into the asthma group and the non-asthma group.Clinical characterizations and BPT results,lung function,fractional exhaled nitric oxide(FeNO)test,blood routine and the levels of serum IgE were collected.The data were compared between the two groups and the risk factors influencing the diagnosis of asthma were analyzed.Results A total of 304 patients,including 217 cases with asthma and 87 with non-asthma,were enrolled.There were significant differences between the asthma group and the non-asthma group in the incidence of wheezing,FeNO,small airway dysfunction,FEV_(1),FEV_(1)/FVC,and eosinophil count more than 300/μl(P<0.05).There was a moderate correlation between FeNO and serum eosinophil count in asthmatic patients(r=0.477),which was higher than that in non-asthmatic patients(r=0.272).Binary Logistic regression analysis showed that FeNO and small airway dysfunction were independent risk factors for asthma,the sensitivity and specificity of FeNO and small airway dysfunction in the diagnosis of asthma were 38.9%and 87.9%respectively.Conclusion FeNO is moderately correlated with the serum eosinophil count in asthmatic patients.Small airway dysfunction and FeNO can be used as an adjunctive diagnosis of asthma.

关 键 词：哮喘 呼出气一氧化氮试验 嗜酸性粒细胞 小气道功能障碍 

分 类 号：R562.25[医药卫生—呼吸系统]