不同咳喘患者气道高反应性测定的探讨

The assessment of bronchial hyperresponsiveness in several respiratory diseases with cough and wheezing

目的 评价支气管哮喘、吸烟、上呼吸道感染、慢性阻塞性肺疾病 (COPD)及过敏性鼻炎患者气道高反应的特点。方法 测定基础肺通气功能后按钟氏法以二磷酸组织胺 (HA)吸入做支气管激发试验。结果 吸烟组、哮喘组、COPD组、上呼吸道感染组及过敏性鼻炎组的BHR阳性率分别为 2 7. 6 %、1 0 0 %、4 0 . 5 %、4 5 . 0 %及 6 9. 2 %。吸烟组、上呼吸道感染组及COPD组与哮喘组、过敏性鼻炎组比较均有显著性差异 (P <0 . 0 0 1 ) ,哮喘组与过敏性鼻炎组比较无显著性差异 (P >0 . 0 5 )。哮喘组支气管激发试验前后 5 0 %及 2 5 %用力肺活量时呼气流速 (V50 、V2 5)比较有显著性差异 ;哮喘组PD2 0 FEV1 His与PEF5 0 %及PEF5 0 % 75 %的降低程度存在显著负相关。结论 哮喘患者均有气道反应性增高 ,但有气道高反应性者并非均为哮喘。

Objective To evaluate the characteristics of bronchial hyperresponsiveness (BHR) in several clinical conditions with cough and wheezing.Methods The patients with bronchial asthma,common cold,COPD and allergy rhinitis as well as subjects who were smoking were enrolled.The routine lung function and bronchial histamine provocation test were underwent.Results The positive rate of BHR were significantly different in five clinical entities mentioned above with the highest in asthma and allergic rhinitis.The degree of BHR in smokers,in patients with common cold and COPD were remarkedly heterogenous (smoking vs common cold,P<0.05;common cold vs COPD,P<0.01) but significantly milder than those in asthma and allergic rhinitis.A significant correlation between PD 20FEV 1-His and the fall of PEF50% or PEF50%-75% was revealed only in patients with asthma.Conclusion The patients of asthma always exhibit BHR,however,BHR do not exclusively indicate the diagnosis of asthma.