122例哮喘患者舒张试验结果分析

Analysis of the bronchodilator test of 122 patients with asthma

目的分析哮喘患者肺功能和支气管舒张试验结果及特点,探讨肺功能检查对哮喘诊断、疗效判断的价值。方法收集2018年入住山东大学第二医院呼吸内科、确诊为哮喘患者的肺功能检查资料,共计122例,根据FEV1/FVC%分为肺功能正常组(30例)及气流受限组(92例),其中气流受限组根据一秒量FEV1分为3个亚组(轻度组63例、中重度组16例、重度组13例),分析各组肺功能及舒张试验数据。结果正常组、轻度组、中重度组、重度组支气管舒张试验阳性率分别为16.7%、58.7%、81.3%、100.0%,组间差异有统计学意义(χ2=35.8,P=0.001);在正常组,FEV1和FVC的改善量、改善率差异无统计学意义(P=0.39,P=0.14);在气流受限组,中重度组及重度组一秒率试验前、试验后数值低于轻度组,差异有统计学意义(试验前:χ2=52.16,P<0.001;试验后:χ2=49.49,P<0.001);各组的试验后一秒率均较试验前升高,差异有统计学意义(P均<0.05);舒张试验后,解除气流受限者仅占9.8%,且均为轻度组。结论哮喘患者支气管舒张试验结果提示,随阻塞程度加重,呈现阳性率渐增趋势。肺功能正常也可行舒张试验,阳性病例呈特殊流速-容量环表现。哮喘治疗与控制是终生的、个体化的,定期复查肺功能,有助于指导临床治疗及全程哮喘管理。

Objective To analyze the results and characteristics of pulmonary function test and bronchodilator test in patients with asthma,and to explore the value of pulmonary function test in diagnosis and curative effect of asthma.Methods Pulmonary function results of 122 patients with asthma in 2018 were collected.According to FEV1/FVC%,the cases were divided into normal group(n=30)and airflow restricted group(n=92).Airflow restricted group was further divided into mild group(n=63),moderately severe group(n=16)and severe group(n=13)based on FEV1.Then the data of different groups were analyzed.Results The positive rates of bronchodilator test were 16.7%,58.7%,81.3%,and 100.0%in normal group,mild group,moderately severe group,and severe group,respectively,with a statistical difference between different groups(χ~2=35.8,P=0.001).There was no significant difference of improvement quantity and improvement rate between FEV1 and FVC in normal group(P=0.39,P=0.14).FEV1/FVC%values before and after bronchodilator test in moderately severe group and severe group were lower than that in mild group(before the test:χ~2=52.16,P<0.001;after the test:χ~2=49.49,P<0.001).FEV1/FVC%value was increased after bronchodilator test in all airflow restricted groups(all P<0.05).Only 9.8%of patients were released from air restriction after bronchodilator test,which were entirely from mild group.Conclusion Positive rate of bronchodilator test increases depending on the aggravation of airflow obstruction in patients with asthma.The patients with normal pulmonary function can also reveive the bronchodilator test.Specific flow volume loops are showed in positive cases of normal group.It is a lifelong process and needs individualized management in the control or treatment of asthma.Pulmonary function test examined regularly is beneficial to guide clinical treatment and manage asthma.