哮喘儿童支气管舒张试验药物选择及间隔时间的临床研究

Clinical study on selection of drugs and interval time for bronchodilator test in children with asthma

目的 探讨哮喘儿童支气管舒张试验药物的选择与间隔时间对试验结果的影响。方法 74例6~14岁支气管哮喘患儿,随机分为A组和B组,每组37例。A组常规肺功能检查后雾化吸入沙丁胺醇,B组常规肺功能检查后给予沙丁胺醇+异丙托溴铵。两组在15、30、60 min再次进行肺通气检查,比较两组不同时间第一秒用力呼气容积(FEV1)、呼出肺活量50%时的用力呼气流速(FEF50)、呼出肺活量75%时的用力呼气流速(FEF75)、用力呼气中期流量(MMEF)的改善阳性率。结果 间隔时间15、30、60 min,A组FEV1改善阳性率分别为40.5%、40.5%、35.1%,FEF50改善阳性率分别为48.6%、45.9%、35.1%,FEF75改善阳性率分别为48.6%、51.4%、32.4%,MMEF改善阳性率分别为51.4%、45.9%、37.8%;B组FEV1改善阳性率分别为18.9%、32.4%、62.2%,FEF50改善阳性率分别为32.4%、94.6%、27.0%,FEF75改善阳性率分别为29.7%、89.2%、75.7%,MMEF改善阳性率分别为18.9%、32.4%、62.2%;间隔时间15、30、60 min,A组FEV1、FEF50、FEF75、MMEF改善阳性率比较,差异无统计学意义(P>0.05)。B组组内不同时间的FEV1、FEF50、FEF75、MMEF改善阳性率比较,差异有统计学意义(P<0.05)。间隔时间15、30、60 min,两组组间FEV1、FEF50、FEF75、MMEF改善阳性率比较,差异有统计学意义(P<0.05)。结论 联合应用沙丁胺醇和异丙托溴铵进行舒张试验,延长间隔时间后增加支气管舒张试验的阳性率,对提高哮喘的诊断率及治疗有重要的临床意义。

Objective To discuss the effect of selection of drugs and interval time for bronchodilator test in children with asthma.Methods A total of 74 children aged 6 to 14 years with bronchial asthma were randomly divided into group A and group B,with 37 cases in each group.Group A was given aerosol inhalation of salbutamol after routine pulmonary function test,and group A was given salbutamol and ipratropium bromide after routine pulmonary function test.Pulmonary ventilation test was performed again at 15,30 and 60 min in both groups.The positive rates of forced expiratory volume in one second(FEV1),forced expiratory flow rate(FEF50)at 50%of vital capacity,forced expiratory flow rate(FEF75)at 75%of vital capacity and maximum mid-expiratory flow(MMEF)were compared between the two groups at different intervals.Results At intervals of 15,30 and 60 min,in group A,the improvement rates of FEV1 were 40.5%,40.5%and 35.1%,the improvement rates of FEF50 were 48.6%,45.9%and 35.1%,the improvement rates of FEF75 were 48.6%,51.4%and 32.4%,and the improvement rates of MMEF were 51.4%,45.9%and 37.8%;in group B,the improvement rates of FEV1 were 18.9%,32.4%and 62.2%,the improvement rates of FEF50 were 32.4%,94.6%and 27.0%,the improvement rates of FEF75 were 29.7%,89.2%and 75.7%,and the improvement rates of MMEF were 18.9%,32.4%and 62.2%.There was no statistically significant difference in the improvement rates of FEV1,FEF50,FEF75 and MMEF in group A at the interval of 15,30 and 60 min(P>0.05).The improvement rates of FEV1,FEF50,FEF75 and MMEF in group B at different time were compared,and the difference was statistically significant(P<0.05).The improvement rates of FEV1,FEF50,FEF75 and MMEF were statistically significant between the two groups at the interval of 15,30 and 60 min(P<0.05).Conclusion The combination of salbutamol and ipratropium bromide for bronchodilator test increases the positive rate of bronchodilator test after prolonging the interval time,which is of great clinical significance for improving the diagnostic rate of asthma.