脉冲振荡肺功能(IOS)评价临床控制的支气管哮喘患者外周气道功能状态

Evaluation of IOS on peripheral airway function in controlled asthmatic patients

目的探讨达到临床控制及部分控制的支气管哮喘患者在支气管舒张试验前后的外周气道功能状态。方法采用前瞻性研究方法,对我院60例已明确诊断为支气管哮喘患者经规范化诊治3月后行哮喘控制测试(ACT)评分、行脉冲振荡肺功能检测(IOS)气道阻力及常规通气功能后给予沙丁胺醇气雾剂200μg吸入,15 min后再次测定气道阻力及常规通气功能。同时选择30例对照者行气道阻力及常规通气功能检测。了解我院支气管哮喘患者控制情况,支气管舒张试验阳性率情况,并观察支气管舒张前后气道阻力及通气功能变化及其相关性。结果 (1)我院哮喘规范化治疗3月后临床控制率为56.9%;(2)临床控制哮喘患者支气管舒张试验阳性率为12.1%,部分控制组支气管舒张试验阳性率为45%;(3)与对照组相比,哮喘控制组及部分控制组外周气道阻力仍明显升高,控制组中心气道阻力与对照组差异无统计学意义,支气管舒张试验后外周气道阻力下降幅度大于中心气道阻力,结论 (1)支气管哮喘规范化诊治后临床控制率为24.5%;(2)支气管哮喘临床控制后仍存在气道高反应性;(3)即使在控制水平的支气管哮喘患者,仍存在外周气道阻力升高,且随着控制水平的降低而加重。IOS可用于评估哮喘外周气道功能状态。

Objective To observe the peripheral airway function before and after bronchial dilation test （BDT） in asthmatic pa- tients at controlled and partly-controlled levels. Methods 3 months after the standard treatment, 60 asthmatic patients were given the tests of ACT and IOS, and then were treated with 200 ug of salbutamol aerosol. 15 minutes later, airway resistance and normal ventilation function were tested again. At the same time, 30 healthy people were selected to detect their airway resistance and normal ventilation func- tion as the control group. The positive reaction before and after BDT, airway resistance and pulmonary ventilation were evaluated and com- pared between the two groups. Results The rate of asthma control was 56.9% 3 months after the conventional treatment, and the positive rate of in controlled BDT was 12. 1%, and 45% at partly-controlled level. The peripheral airway resistance was significantly higher in the study group than in the control group, and there was no obvious difference on central airway resistance between the two groups. The clini- cal control rate of bronchial asthma through conventional treatment was 24. 5%. There still existed airway hyperreactivity in patients with controlled bronchial asthma. Conclusion IOS can be used to evaluate the peripheral airway function in asthmatic patients.