老年哮喘患者气道可逆性研究

A Survey of the Airway Reversibility of Old Patients with Asthma

目的 通过与青年哮喘病人的对比,评价老年哮喘病人的气道可逆性变化情况。方法 对56例老年哮喘病人与61例青年哮喘病人分别进行FEV1％测定,并吸入舒喘灵进行支气管舒张试验,对其FEV1改善(△FEV1％)<15％者,再进行口服1周的糖皮质激素试验,然后对比分析。结果 青年组哮喘病人吸入舒喘灵后的△FEV1％及舒张试验阳性率(分别为13.1±10.1和39.3％),均高于老年组(分别为7.2±12.31和17.9％)。但急性支气管舒张试验阴性病人口服激素后的△FEV1％及阳性率,两组相比无显著性差异。按病程≤5年和>5年,分为长、短病程两组,青年组中的短病程组△FEV1％及阳性率,均高于长病程组,而老年组中的病程长短对其未见影响。结论 年龄和病程均对支气管哮喘病人的气道可逆性产生影响,老年哮喘的气道可逆性较青年人低,但对口服激素的反应却与青年人无明显差别,老年哮喘的病程对气道可逆性的影响比青年人小。

Objective Evaluating the effect of aging on airway reversibility by comparing young and old patients with asthma. Methods We compared two groups of patients with asthma;older group,which had 56 cases(22 men and 34 women) aged 59. 2±5. 1 years (mean±SD),and younger group,comprised of 61 cases (26 men and 35 women)who were 32. 4±6.5 years old. Spirometric examination and a bronchodilator(salbutamol,200ug) test was performed. The cases who not reaching 15% of △FEV1% were submitted to a 7-day course of oral steriods (prednisone, 30mg,qd). Results Although △FEV1 % and positive subjects of younger group responded to the acute bronchodilator test was higher (13. 1±10. 1vs7. 2±12. 3 and 39. 3%vs17. 9%) (both P<0.05), the response achievable with steroid treatment was not statistically different between groups(18. 5±17. 2vs14. 1±19. 3 and 24. 3vs23. 9,respectively)(both P>0. 5). Separating two group by disease duration≤5 year and >5 years,the △FEV1% and positive subjects of≤5yr group were higher in younger group comparing>5yr group (P <0. 005),but in older group,the △FEV1% and positive subject were not statistically different between≤5yr group and>5yr group. Conclusions Both the age and disease duration effect the airway reversibility of the subjects with asthma. The older patients have a badly responsiveness to bronchodilator, but the response to oral steroid has no difference comparing the younger patients with asthma. The asthmatic disease duration have a small effects on airway reversibility in older subjects compring in younger.