哮喘患者气道阻力随年龄变化趋势的肺功能研究

Pulmonary function study of airway resistance change with different age in asthmatic patients

目的了解哮喘急性发作患者与年龄相关的肺功能特点,探讨哮喘发作期患者气道阻力随年龄变化的发展趋势。方法回顾因哮喘急性发作在我院就诊的173名患者的临床和肺功能资料,比较40岁以下组、40-60岁组、60岁以上组在常规肺功能参数FEV_1、FEV_1/FVC、FEF_(25%-75%)以及脉冲振荡肺功能参数R_(20)、R_(10-R20)、R_5-R_(10)的差异。研究对象均为非吸烟哮喘患者。结果 40岁以下哮喘急性发作患者,其远端气道阻力R5-R10明显低于40-60岁组和60岁以上组(P<0.05)。40岁以下组FEF_(25%-75%)和FEV_1/FVC明显高于60岁以上组(P<0.05)。大气道阻力R_(20)在40岁以下组高于60岁以上组(P<0.05)。结论非吸烟的哮喘急性发作患者,随年龄的增加,近端气道阻力逐渐减小,远端气道阻力逐渐增加,FEV_1/FVC逐渐下降。哮喘急性发作的肺功能结果随年龄变化的特点,提示根据年龄的差异而进行个体化的治疗,可能是更适合不同哮喘患者的方法。

Objective To study the pulmonary function features of acute asthmatic patients and to find the characteristics of airway resistance in different ages. Methods The pulmonary function test results of 173 asthmatic patients were reviewed. The patients were divided into 3 groups according to age. Parameters as FEVl , FEV1/FVC, FEF25% -75%, R20, R1o - R20 and R5 - R10 were compared between the two groups. Results In patients who were younger than 40 years old, their distal airway resistance manifested by R5 - R10 was significantly lower than those ol- der than 40 （ P 〈 0.05 ）. FEF25%-75% and FEV1/FVC were higher in patients under 40 than in patients over 60 （ P 〈 0. 05 ）. Central airway resistance as manifested by R2o was higher in patients under 40 than in patients over 60 （P 〈 0.05 ）. Conclusion In patients with acute asthma attack, there is a trend of growing resistance in small airways with the advance of age while a decrease of resistance in central airways. This finding suggests that treatment tailored by age groups is hopefully better than we adopted nowadays.