小气道功能与气道高反应性的相关性分析

The correlation analysis between small airway function and airway hyperresponsiveness

目的分析小气道功能与气道高反应性的相关性。方法对272例疑似哮喘患者行基础肺功能及支气管激发试验,分析其小气道功能与气道高反应性之间的关系。结果支气管激发试验阳性组患者最大中期呼气流速占预计值百分比(MMEF%pred)、呼气峰值流速占预计值百分比(PEF%pred)、用力呼气75%、50%、25%肺活量的瞬时流速占预计值百分比(FEF75%pred、FEF50%pred、FEF25%pred)明显低于支气管激发试验阴性组,差异有统计学意义(P<0.05);小气道功能异常组支气管激发试验阳性率明显高于正常组(86.0%vs 54.0%),差异有统计学意义(χ2=19.347,P<0.01);MMEF75/25%pred、FEF75%pred、FEF50%pred、FEF25%pred、PEF%pred作受试者工作特征曲线,曲线下面积分别为0.702(95%CI:0.640~0.764)、0.654(95%CI:0.588~0.720)、0.704(95%CI:0.642~0.765)、0.723(95%CI:0.662~0.784)及0.682(95%CI:0.616~0.749),各指标与参考线下面积0.5相比,均差异有统计学意义(P<0.05);PD20FEV1与MMEF75/25%pred、FEF75%pred、FEF50%pred、FEF25%pred、PEF%pred均呈正相关性,相关系数分别为0.524、0.439、0.540、0.418、0.276。结论与气道反应性正常的患者相比,存在气道高反应性的患者小气道功能明显偏低;小气道功能异常的患者行支气管激发试验可能更易出现阳性结果;小气道功能某种程度上可以反映气道高反应性的严重程度。

Objective To analyze the relationship between small airway function and airway hyperresponsiveness. Methods 272 suspected asthma patients were enrolled in this study, then conventional pulmonary function tests and bronchial provocation tests was performed, and the relationships between small airwaindieators and BPT results were analyzed. Results The differences between BPT negative group and positive group were statistically significant in MMEF% pred,PEF%pred, FEF75% pred,FEF50% pred,FEF25% pred （P 〈0. 05） ;The positive rate of the bronchial provocation tests of the abnormal small airway function group was obviously higher than that of normal group （86. 0% vs 54. 0% ）, thedifference was statistically significant （ X2 = 19. 347 ,P 〈0. 01 ） ;The area under the receiver operating characteristic curve of percentage predicted values （ % pred） for maximal midexpiratory flow, the forced expiratory flow at 75% ,50% ,25% of vital capacity and peak expiratory flow（ MMEF75/25% pred,FEF75% pred, FEF50% pred, FEF25% pred, PEF% pred） was 0. 524, O. 439,0. 540,0. 418,0. 276 respectively. The index compared with an area of 0. 5 the reference line covered , differences were statistically significant （ P 〈 0. 05 ） ; PD20FEV1 was positively correlated with MMEF75/25% pred, FEF75% pred, FEF50% pred, FEF25% wed, PEF% pred, the correlation coefficient was 0. 702 （ 95 % CI： 0. 640 - 0. 764 ）, 0. 654 （ 95 % CI： 0. 588 - 0. 720 ）, 0. 704 （95% CI：0. 642 - 0. 765 ） , 0. 723 （ 95% CI： 0. 662 - 0. 784） , 0. 682 （ 95% CI： 0. 616 - 0. 749 ） respectively. Conclusion Small airway function of patients with airway hyperresponsiveness was significantly lower than patients with normal airway reactivity. Bronchial provocation tests in the patients with abnormal small airway function may be more likely to appear positive results. Small airwayfunction, tosome extent, can reflect the severity of airway hyperresponsiveness.