支气管哮喘、咳嗽变异性哮喘及急性支气管炎气道反应性特点及意义

目的探讨支气管哮喘、咳嗽变异性哮喘及急性支气管炎气道反应性特点，以便为临床诊断提供依据。方法采用日本产ＡＳＴＯＧＡＰＨＴＣＫ６０００ＣＶ气道反应测定仪，以乙酰甲胆碱为气道激发剂，观察６０例支气管哮喘、５８例咳嗽变异性哮喘及３７例急性支气管炎患者气道反应性变化。结果支气管哮喘和咳嗽变异性哮喘病人气道激发试验均为阳性，哮喘病人的气道反应阈值（Ｄｍｉｎ）低于咳嗽变异性哮喘病人（Ｐ＜００５）。急性支气管炎病人中，气道激发试验３３例阴性，占８９％，４例阳性，占１１％。４例阳性急性支气管炎患者的气道反应性曲线与哮喘组及咳嗽变异性哮喘组明显不同，其Ｄｍｉｎ也显著高于哮喘组（Ｐ＜００１）及咳嗽变异性哮喘组（Ｐ＜００５）。结论气道反应性测定对于不同类型哮喘及急性支气管炎的鉴别和指导治疗具有很好的临床应用价值。

The features of airway reactivity in bronchial asthma,cough variant asthma and acute bronchitis

Objective It was reported that there was airway hyperresponsiveness (AHR) in bronchial asthma and cough variant asthma,but was not in acute bronchitis.Our subjective is to investigate the features of airway reactivity in bronchial asthma,cough variant asthma and acute bronchitis.So as to provide scienticfic basis for diagnosis of bronchial asthma,cough variant asthma and acute bronchitis.Methods The airway reactivity to inhalation of methacholine had been tested in 60 cases of bronchial asthma,58 ght cases of cough variant asthma and 37 subjects of acute bronchitis with airway reactivity apparatus of ASTOGAPH TCK 6000cv.Results It was found that all of the bronchial asthma and cough variant asthma were positive in the tests of airway reactivity.Thirty-three patients with acute bronchitis were negative,but four subjects of acute bronchial were positive in the examination.The Dmin(minimum dose of methacholine) of bronchial asthma was very significantly lower than that of cough variant asthma ( P <0.05),and than that of acute bronchitis ( P <0.01).Conclusion There were different airway reactivitys in bronchial asthma,cough variant asthma and acute bronchitis.The reactivity of bronchial asthma was more sensitive to methacholine than those of cough variant asthma and acute bronchitis.The airway reactivity examination is very useful in diagnosis and treatment in the three groups of patients.