气道反应性增高的危险因素分析

目的:分析气道高反应性的危险因素.方法:对怀疑支气管哮喘的患者行支气管激发试验,按检查结果分为研究组(气道反应增高,n=88)和对照组(气道反应正常,n=114),比较两组的临床指标；同时应用logistic回归分析筛选气道高反应的危险因素.结果:研究组和对照组的喘息症状发生率(10.2％ vs 0.9％)、病程＞1年(34.1％ vs 7.0％)、吸烟率(44.3％ vs 29.8％)、过敏性鼻炎发生率(31.8％ vs 13.2％)、哮喘家族史(52.3％ vs7.0％)及小气道功能异常发生率(40.9％ vs 20.2％)均有显著差异；年龄＜40岁(OR值2.800),病程＞1年(OR值13.051)、喘息症状(OR值32.743)、过敏性鼻炎病史(OR值3.380)、哮喘家族史(OR值26.811)和小气道功能异常(OR值4.228)是气道高反应的危险因素.结论:应用一些简单、易测的临床指标能协助预测气道反应性增高,其中喘息症状、病程＞1年和哮喘家族史具有较高的预测价值.

Analysis of Risk Factors of Airway Hyper-responsiveness

Objective： To investigate risk factors of airway hyper-responsiveness. Methods： Bronchial provocation test was carried out on patients with symptoms of asthma. The cases were divided into research group （airway hyper-responsiveness,n=88） and control group （normal airway responsiveness,n=114） according to the bronchial provocation test. The data of clinic were compared between the two groups and risk factors of airway responsiveness were analyzed by binary logistic regression analysis. Results： There were significant difference between research group and control group in incidence of gasping（ 10.2% vs 0.9%）, a symptomatic period 〉 1 year（34.1% vs 7.0%） ,smoking （44.3% vs 29.8%）,allergic rhinitis （31.8% vs 13.2%）,family history of asthma （52.3% vs 7.0%） and dysfunction of small airway（40.9% vs 20.2%）. Variables,which in a multivariate model include years of age〈40 （ OR 2.800）, a symptomatic period 〉 1 year （OR 13.051 ）, gasping （OR 32.743）, allergic rhinitis （ OR 3.380）, family history of asthma （OR 26.811 ） and dysfunction of small airway （OR 4.228） were associated with airway hyper- responsiveness. Conclusion： Clinic variables permit different risk levels of airway hyper-responsiveness in patients with symptoms of asthma, among which gasping, a symptomatic period 〉 1 year and family history of asthma present good predictable ability of airway hyper-responsiveness.