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目的探讨支气管舒张试验在小气道病变患者中临床应用方面的价值,观察其对早期支气管哮喘有无预测价值。方法根据小气道病变诊断标准选取郑州大学第五附属医院门诊及住院部的104例小气道病变患者,观察所有患者支气管舒张试验的结果,并追踪患者病情转归。结果 104例患者中有33例阳性,71例阴性。阳性组和阴性组舒张前FEF25-75%、FEF50%(V50%)、FEF75%(V25%)比较差异有统计学意义(P<0.05),舒张前FEF25-75%、FEF50%(V50%)、FEF75%(V25%)与FEV1改善率和增加量均呈负相关。33例支气管舒张试验阳性患者中有23例患者确诊为支气管哮喘,小气道病变患者的支气管哮喘的发生率为21.02%。结论支气管哮喘可能多合并小气道病变,考虑小气道病变患者应早期行支气管舒张试验,该试验在小气道病变患者中的应用对支气管哮喘的发生可能有预测价值。
Objective To investigate the clinical value of bronchial diastolic test in patients with small airway disease and to investigate the predictive value of bronchial diastolic test for early bronchial asthma. Methods Based on the diagnostic criteria of small airway lesions, 104 patients with small airway disease in outpatient department and inpatient department of the Fifth Affiliated Hospital of Zhengzhou University were selected to observe the results of bronchodilator test in all patients and follow-up of patients’ condition. Results Of the 104 patients, 33 were positive and 71 were negative. Pre-diastolic FEF25-75%, FEF50% (V50%) and FEF75% (V25%) in positive and negative groups were significantly different (P <0.05), pre-diastolic FEF25-75%, FEF50% , FEF75% (V25%) and FEV1 improvement rate and increase were negatively correlated. Twenty-three of the 33 patients with positive bronchodilator tests were diagnosed as bronchial asthma. The incidence of bronchial asthma in patients with small airway disease was 21.02%. Conclusions Bronchial asthma may be complicated by small airway disease. Patients with small airway disease should be treated with bronchodilatation test early. The application of this test in patients with small airway disease may have predictive value for the occurrence of bronchial asthma.