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目的:探讨与研究支气管扩张剂治疗有效和无效咳嗽变异性哮喘的临床疗效和价值。方法:选择我院收治的咳嗽变异性哮喘患者共50例纳入研究,依据患者对支气管扩张剂治疗是否有效分为支气管扩张剂有效组(有效组)和支气管扩张剂无效组(无效组),分析比较两组患者的一般临床资料,肺通气功能指标及气道反应性,辣椒素咳嗽敏感性和诱导痰炎症细胞数及分类计数。结果:有效组占所有变异性哮喘人数的60.00%,无效组占40.00%;有效组肺通气各项指标中如FEV1、FVC、FEV1/FVC和MMEF及PD20FEV1与无效组相比有下降趋势,但统计分析差异不显著,P>0.05;有效组诱导痰中嗜酸性粒细胞比例、上清液中PGD2及ECP水平明显高于无效组,差异显著,P<0.05;有效组咳嗽阈值log C5低于无效组,差异有统计意义,P<0.05;有效组治疗后咳嗽症状积分改善分值与诱导痰中嗜酸性粒细胞比例、组胺、PGD2及ECP水平为正相关关系,与log C5为负相关关系。结论:咳嗽变异性哮喘存在支气管扩张剂治疗有效及无效两种分型,两者发生机制可能存在不同,且不同气道炎症介质水平引起的支气管收缩不同程度可能是影响支气管扩张剂临床疗效的重要因素。
Objective: To investigate and study the clinical efficacy and value of bronchodilator in the treatment of effective and ineffective cough variant asthma. Methods: A total of 50 patients with cough variant asthma admitted to our hospital were included in the study. Based on whether patients were effectively treated with bronchodilators, they were divided into two groups: effective group (effective group) and ineffective group (effective group); bronchodilator ineffective group The clinical data of the two groups were compared, pulmonary function index and airway responsiveness, the sensitivity to capsaicin and the number of inflammatory cells induced by sputum and the classification and counting. Results: The effective group accounted for 60.00% of all the patients with variant asthma, and the inactive group accounted for 40.00%. In the effective group, the indexes of FEV1, FVC, FEV1 / FVC, MMEF and PD20FEV1 showed a downward trend compared with the invalid group Statistical analysis showed no significant difference (P> 0.05). Efficacy of induced sputum eosinophil ratio, PGD2 and ECP levels in supernatant was significantly higher than that in ineffective group, the difference was significant, P <0.05; effective group cough threshold log C5 Invalid group, the difference was statistically significant, P <0.05; effective group after treatment cough symptom score improvement score induced sputum eosinophil ratio, histamine, PGD2 and ECP levels were positively correlated with the log C5 negative correlation relationship. CONCLUSION: There are two types of effective and ineffective bronchodilator therapy for cough variant asthma. The mechanism of the two may be different, and different levels of bronchoconstriction induced by different airway inflammatory mediators may be important for the clinical efficacy of bronchodilator factor.