咳嗽变异型哮喘与慢性喘息型支气管炎患者肺功能变化的探讨

Characteristics of Pulmonary Function Changes in Cough Variant Asthma and Chronic Asthmatic Bronchitis

为了解咳嗽变异型哮喘（咳型哮喘）与慢性喘息型支气管炎（慢喘支）患者的肺功能变化特征，作者对３０例咳型哮喘和２５例慢喘支患者的临床及肺功能改变进行了探讨。结果：两组患者的病史和临床表现有显著性差异（Ｐ＜０．０５）；咳型哮喘组患者的最大呼气流量、最大呼气中段流量和一秒钟用力呼气容积测值基本正常，而慢喘支组则明显下降；激发试验中咳型哮喘１００％显示阳性，而慢喘支组阳性者不足１／４；阳性时咳型哮喘所需激发剂平均浓度与慢喘支相比为１∶４．７，明显低于后者，且两者的阳性浓度极少交叉。上述结果提示，尽管咳型哮喘与慢喘支患者的临床表现有某些相似之处，但两者仍有明显差别。

To understand with greater clearness the characteristics of pulmonary function changes in patients with cough variant asthma (CVA) and patients with chronic asthmatic bronchitis(CAB), 30 cases of CVA and 25 cases of CAB were examined by pulmonary function test and were compared clinically. The results showed the differences in medical history and some clinical manifestations between the two groups were significant ( P<0.05 ). The expiratory flow parameters (PEF, MMEF, FEV 1) of pulmonary function test in CVA were generally normal; these parameters in CAB group, however, were obviously decreased. The airway challenge test uncovered a 100% positive reaction in CVA patients, but only less than 1/4 of the patients with CAB showed positive reaction. Furthermore, the positive concentration of challenge agents (Mch) required for CVA group was 1/4.7 of the ones for CAB group, and the positive Mch concentrations of the two groups seldom crossed each other. It is concluded that some clinical manifestations of CVA and CAB were significantly different, although many similarities between them do exist; the MEFV curve in pulmonary function test and the airway challenge test can be used to differentiate them well.