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目的了解职业性哮喘患者的肺功能变化特点。方法对15例职业性哮喘患者行支气管现场激发试验时的肺功能参数进行分析,并同时记录发生时间及患者症状、体征。结果①发作期和激发前肺功能值比较,大部分肺功能参数差异有统计学意义(P<0.05)。发作期用力肺活量(FVC)、第1秒用力呼气容量(FEV1)、最大用力呼气流速(PEF)、最大呼气中段流速(MMEF)、25%和50%肺活量时的最大呼气流速(FEF25、FEF50)显著低于激发前;②经直线相关分析,FEV1与FVC下降率之间,FEF50与MMEF下降率之间以及FEV1与MMEF下降率之间均呈直线相关(rs=0.825,P=0.006;rs=0.992,P=0.000;rs=0.881,P=0.004)。③激发后60 min内现场支气管激发试验阳性10例,且全部出现全身发汗、颜面发绀及肺部哮鸣音等严重临床表现,占67%;激发2 h后的现场支气管激发试验阳性5例,占33%。结论职业性变应原致使患者的大小气道功能受限,职业性哮喘可呈速发相反应或迟发相反应。呈速发相反应患者的临床表现明显。
Objective To understand the characteristics of pulmonary function in patients with occupational asthma. Methods Fifteen cases of occupational asthma patients undergoing field test of bronchial lung function parameters were analyzed, and at the same time record the time of occurrence and the patient’s symptoms and signs. Results ① There was significant difference in most pulmonary function parameters between attack and pre-challenge lung function (P <0.05). FVC, FEV1, PEF, MMEF, maximal expiratory flow at 25% and 50% of vital capacity (FVC), FEV1 (forced expiratory volume in 1 second), maximum forced expiratory flow (PEF) FEF25, FEF50) was significantly lower than that before stimulation; ②According to the linear correlation analysis, there was a linear correlation between the decreasing rate of FEV1 and FVC, the decreasing rate of FEF50 and MMEF, and the decreasing rate of FEV1 and MMEF (rs = 0.825, P = 0.006; rs = 0.992, P = 0.000; rs = 0.881, P = 0.004). ③ In 60 minutes after the challenge, 10 cases were positive in the field bronchial provocation test, and all of them showed severe clinical manifestations of systemic sweating, facial cyanosis and pulmonary wheeze, accounting for 67%; 5 cases of live bronchial provocation test after 2 hours’ excitation, Accounting for 33%. Conclusion Occupational allergens cause limited size and airway function in the patients. Occupational asthma may show either immediate or late phase reaction. Patients showed rapid clinical response to the obvious clinical manifestations.