慢性咳嗽患者的呼吸生理指标研究

Analysis of Respiratory Physical Indicators in Patients with Chronic Cough

目的分析慢性咳嗽患者的呼吸生理指标,研究基础肺功能与支气管激发试验二者之间的关系。方法对69例慢性咳嗽患者行常规肺功能检测后加测支气管激发试验,观察用力肺活量(FVC)、第1秒用力呼气容积(FEV1)、第1秒用力呼气容积占预计值百分比(FEV1%)、最大呼气峰流速(PEF)、最大呼气峰流速占预计值百分比(PEF%)、最大呼气中期流速(MMEF)及最大呼气中期流速占预计值百分比(MMEF%)的变化状况,并观察激发试验后肺功能上述几项指标下降及下降率与激发药物浓度之间的关系。结果 69例受试者当中,基础肺功能正常45例,占总受试人数的65.22%;小气道功能异常者24例,占总受试人数的34.78%。45例基础肺功能正常者支气管激发试验阳性或接近阳性(由于激发试验引起剧烈咳嗽而终止)30例,占基础肺功能正常人数的66.67%。相比之下,24例小气道功能异常者加测支气管激发试验后11例为阳性,占45.83%。结论对于慢性咳嗽患者,尽管基础肺功能检测正常,也应将支气管激发试验作为常规检测项目,以筛选出由气道高反应引起的慢性咳嗽,及时给予正确的治疗。

Objective To study the respiratory physiological indexes and the relationship between basic lung function and positive rate of the bronchial provocation in the patients with chronic cough. Methods The conventional lung function and bronchial provocation were conducted for 69 patients with chronic cough in our hospital.The observed indexes included the forced volume capacity（FVC）,first second expiratory volume（FEV1）,percentage ratio of the first second expiratory volume（FEV1%）,peak expiratory flow（PEF）,percentage ratio of the peak expiratory flow（PEF%）,maximum middle expiratory flow（MMEF）,and percentage ratio of the maximum middle expiratory flow（MMEF%）.And the changes of the above-mentioned indexes after the bronchial provocation test and the relationship between decreased rate and provocation drug concentration were also investigated. Results The basic lung function was found to be normal in 45 of the 69 patients accounting for 65.22%,and small airway function was found to be abnormal in 24 of the 69 patients,accounting for 34.78%.Among the 45 patients with basic lung function there 30 whose bronchial provocation test was positive or almost positive（termination of the test due to intensity cough）,accounting for 66.67%.While among the 24 patients with abnormal function of the small airway there were 11 whose bronchial provocation test was positive,accounting for 45.83%. Conclusion Bronchial provocation test should be routinely detected in the patients with chronic cough even for those with normal basic lung function,so as to screen the patients whose chronic cough is caused by airway hypersensitivity and thus give right treatment for them.