支气管舒张试验在小气道病变患者中的临床应用价值

Clinical value of bronchodilator reversibility testing in small airway disease

目的探讨支气管舒张试验在小气道病变患者中临床应用方面的价值,观察其对早期支气管哮喘有无预测价值。方法根据小气道病变诊断标准选取郑州大学第五附属医院门诊及住院部的104例小气道病变患者,观察所有患者支气管舒张试验的结果,并追踪患者病情转归。结果 104例患者中有33例阳性,71例阴性。阳性组和阴性组舒张前FEF25-75%、FEF50%(V50%)、FEF75%(V25%)比较差异有统计学意义(P<0.05),舒张前FEF25-75%、FEF50%(V50%)、FEF75%(V25%)与FEV1改善率和增加量均呈负相关。33例支气管舒张试验阳性患者中有23例患者确诊为支气管哮喘,小气道病变患者的支气管哮喘的发生率为21.02%。结论支气管哮喘可能多合并小气道病变,考虑小气道病变患者应早期行支气管舒张试验,该试验在小气道病变患者中的应用对支气管哮喘的发生可能有预测价值。

Objective To explore the clinical value of bronchodilator reversibility testing in small airway disease and predict value of small airway diseases for asthma.Methods Totally 104 patients with small airway disease were selected on the basis of diagnostic criteria of small airway disease,all cases were examined by spirometry and bronchodilator reversibility testing,and the results were retrospectively analyzed.The outcomes of the all patients were tracked.Results In all the 104 patients examined by bronchodilator reversibility testing 33 patients showed positive results and 71 patients showed negative results.There was significant difference in pre-bronchodilator FEF25-75%,FEF50%（V50%）,FEF75%（V25%） measurement between positive group and negative group（P0.05）.Pre-bronchodilator FEF25-75%,FEF50%（V50%）,FEF75%（V25%） measurement were negatively correlated with improvement rate and absolute change of FEV1 measurement.28 patients were diagnosised with asthma in positive group,the incidence of asthma in small airway disease patients was 21.02%.Conclutions There is necessary to do bronchodilator reversibility testing to patients with small airway disease.