小气道功能障碍哮喘患者肺功能及炎症指标特征  

The pulmonary function and inflammatory indicators in asthmatic patients with small airway dysfunction

作　　者：凌冰毅 郭芳雅 张锐 姜望予 陈芳[2] Ling Bingyi

机构地区：[1]浙江中医药大学第一临床医学院,310053 [2]浙江中医药大学附属第一医院,310006

出　　处：《浙江临床医学》2025年第2期169-171,共3页Zhejiang Clinical Medical Journal

摘　　要：目的探讨小气道功能障碍(SAD)对哮喘患者肺功能及炎症指标的影响。方法回顾性分析2023年5月至2024年5月于浙江省中医院接受治疗的120例支气管哮喘患者临床资料,根据肺功能结果是否存在小气道功能障碍分为SAD组和非SAD组,每组各60例。比较两组患者肺功能、呼出气一氧化氮(FeNO)及血嗜酸性粒细胞(Eos)水平的差异。结果与非SAD组相比,SAD组用力肺活量(FVC)(3.07±0.83 VS.3.49±0.74)、第1秒用力呼气容积(FEV1)(2.35±0.65 VS.3.07±0.67)、呼气峰流量(PEF)(6.00±1.80 VS.7.29±1.41)、用力呼出50%肺活量的呼气流量(FEF50%)(2.29±0.84 VS.4.31±1.07)、用力呼出75%肺活量的呼气流量(FEF75%)(0.78±0.37 VS.1.79±0.79)以及最大呼气中期流量(MMF)实测值(1.83±0.69 VS.3.62±1.05)均减小,差异均有统计学意义(P<0.001)。SAD组残气量增加的患者比例更高(61.67%VS.41.67%,P<0.05)。SAD组的FEF50%改善量(0.82±0.54 VS.1.15±0.72)、FEF75%改善量(0.23±0.26 VS.0.49±0.41)及MMEF改善量(0.60±0.42 VS.0.99±0.65)均减小,差异具有统计学意义(P<0.05)。SAD组血Eos绝对数[(0.08,0.26)VS.(0.06,0.23)]及Eos%均升高[(1.30,3.50)VS.(0.80,2.20)],且差异有统计学意义(P<0.05),血Eos>0.3的患者比例更高(26.67%VS.11.67%),差异有统计学意义(P<0.05)。血Eos绝对数与FEF50%(r=-0.217)、FEF75%(r=-0.214)及MMEF(r=-0.218)均存在相关性(P<0.05)。结论SAD的哮喘患者肺功能及气道可逆性更差,气体潴留增加,存在更严重的炎症反应,早期识别SAD对哮喘慢病管理至关重要。Objective To investigate the impact of small airway dysfunction(SAD)on pulmonary function and inflammatory markers in asthmatic patients.Methods A retrospective study was conducted on the clinical data of 120 patients with bronchial asthma treated at Zhejiang Provincial Hospital of Traditional Chinese Medicine from May 2023 to May 2024.Patients were divided into the SAD group and the non-SAD group based on the the presence of small airway dysfunction,with 60 cases in each group.The differences in pulmonary function,fractional exhaled nitric oxide(FeNO),and blood eosinophil(Eos)levels between the two groups were compare.Results Compared with the non-SAD group,the SAD group had significantly reduced forced vital capacity(FVC)(3.07±0.83 VS.3.49±0.74),forced expiratory volume in the first second(FEV1)(2.35±0.65 VS.3.07±0.67),peak expiratory flow(PEF)(6.00±1.80 VS.7.29±1.41),forced expiratory flow at 50%of vital capacity(FEF50%)(2.29±0.84 VS.4.31±1.07),forced expiratory flow at 75%of vital capacity(FEF75%)(0.78±0.37 VS.1.79±0.79),and maximum mid-expiratory flow(MMF)(1.83±0.69 VS.3.62±1.05),with statistically significant differences(P<0.001).The proportion of patients with increased residual volume in the SAD group was higher(61.67%VS.41.67%,P<0.05).The improvement in FEF50%,FEF75%,and MMEF in the SAD group was reduced(FEF50%:0.82±0.54 VS.1.15±0.72,FEF75%:0.23±0.26 VS.0.49±0.41,MMEF:0.60±0.42 VS.0.99±0.65),with statistically significant differences(P<0.05).The absolute number of blood Eos[(0.08,0.26)VS.(0.06,0.23)]and the percentage of Eos[(1.30,3.50)VS.(0.80,2.20)]were both elevated in the SAD group,with statistically significant differences(P<0.05),and the proportion of patients with blood Eos>0.3 was higher(26.67%VS.11.67%),with statistically significant differences(P<0.05).There was a correlation between the absolute number of blood Eos and FEF50%(r=-0.217),FEF75%(r=-0.214),and MMEF(r=-0.218),with statistically significant differences(P<0.05).Conclusion Asthma patients with SAD have poor pulmonary

关 键 词：支气管哮喘 小气道功能 肺功能 呼出气一氧化氮 血嗜酸性粒细胞 

分 类 号：R56[医药卫生—呼吸系统]