气道高反应性与小气道阻塞关系的分析

A Study of the Relationship between Airway Hyperresponsiveness and Small Airways Occlussion

为了研究气道高反应性与小气道阻塞的关系,寻找早期发现哮喘病人的客观指标,本文对1998～2000年于首教医科大学附属北京朝阳医院肺功能室行支气管激发试验的病人进行了回顾性分析。所选病人均为支气管激发试验阳性,且基础肺功能指标正常(FEV 1.0实测值/预计值>80%)的病人。结果显示,基础肺功能指标正常的病人,其反映小气道功能的指标(FEF25%～75%)已有异常改变,FEF25%～75%实测值/预计值为0.65±0.23。当FEF25%～75%实测值/预计值<0.5时,其与乙酰甲胆碱累积浓度呈显著正相关,P<0.05。由此可见,重度小气道狭窄是气道高反应性的一个主要因素,FEF25%～75%是监测早期肺功能异常的一个敏感指标。

In ordor to study the relationship between airway hyperresponsiveness and small airways occlussion and to discover earlier the objective criteria of asthma, 54 cases were included in this study. Methacholine challenge test was conducted,all cases had positive result and pulmonary function normal. The result showed that the small airway criteria (FEF25%-75% ) of patients who had normal pulmonary function (FEF25%- 75% ) was abnormal. When FEF25%-75%ob/pre was less than 0.5, there was a significant positive relations between FEF25 % -75 % and the concentration of methacholine , P < 0.05. It is concluted that the severe small airways stenosis is a major factor of airway hyperresponsiveness, FEF25 % -75 % is a sensitive criteria of earlier abmormality of .pulmonary function.