哮喘病人舒张试验多项指标的比较及临床意义

Comparison and Clinical Significance of Multiple Indices of Bronchial Dilation Test in Patient With Asthma

目的 :探讨哮喘病人支气管舒张试验多项指标评定标准阳性率的临床应用价值。方法 :对 87例哮喘病人 (肺功能分级轻度 18例 ,中度 39例 ,重度 30例 )吸入万托林 (2 0 0 μg) 15min前后进行F V曲线测定观察各指标的改变率。结果 :轻度组各指标阳性率 (% )FVC、FEV1.0 和PEF为 4 .0、7.6和 15 .2 ,FEF2 5 % 75 %、V· max75、V· max5 0和V· max2 5为 2 4 .2、5 6 .0、34.0和 38.0 ;中度组FVC、FEV1.0 和PEF为 6 .0、5 4 .2和 2 4 .0 ,FEF2 5 % 75 %、V· max75、V·max5 0和V· max2 5为 4 2 .1、75 .0、5 2 .6和 5 8.0 ;重度组FVC、FEV1.0 和PEF为 19.8、6 8.8和 2 9.0 ,FEF2 5 % 75 %、V·max75、V·max5 0和V·max2 5为 6 4 .5、92 .0、70 .0和 6 8.0。结论 :哮喘支气管舒张试验阳性诊断标准不仅是FVC、FEV1.0和PEF ,还应综合考虑其他各项指标的变化 ,以使诊断评价更为客观。

Objective: Our aim was evaluate the clinical application of mutiple indices positive rate in patients with asthma. Metheds: Patients (87) with asthma were graded by their lung function test: 18 with mild, 39 with moderate, and 30 with severe asthma changes of indices were observed by measuring the F-V curves before and 15 minutes after inha-ling bronchodilator (200μg of salbu tamol). Results: In the mild group, the positive rates of FVC, FEV 1 and PEF were 4.0%,7.6%,and 15.2%,respectively; and FEF25%-75%, V·max75, V·max50, and V·max25were24.2%,56.0%,34.0%, and38.0%,respectively.Inthemoderategroup, the positive ratesof FVC,FEV 1 andPEF were6.0%,54.2%,and24.0%, respectively; and FEF25%-75%, V·max75, V·max50, and V·max25 were 42.1%, 75.0%, 52.6%, and 58.0%, respectively. In the severe group, the positive of FVC, FEV 1.0 and PEF were 19.8%, 68.8%, and 29.0%, respectively; and FEF25%-75%, V·max75, V·max50, and V·max25 were 64.5%, 92.0%, 70.0%, and 68.0%. Conclusion: In the diagnosis of asthma, the criteria of bronchodilation test should include not only the FVC, FEV 1.0, and PEF, but also the other indices. Shch as FEF25%-75%, V·max75, V·max50 and V·max25.