选择性肺功能检查在老年支气管哮喘诊断中的价值

目的：探讨肺功能试验在老年支气管哮喘（老年哮喘）诊断中的价值。方法：对临床诊断为哮喘的６３ 例老年病人进行基础肺功能、支气管扩张试验（支扩试验）、支气管激发试验（激发试验）等项检查，并与１３７ 例 ３０ 岁以下的青年哮喘患者进行比较。结果：老年组基础肺功能各值大部分较青年组低（ Ｐ＜ ０．０５）。老年组中支气管扩张试验阳性率为８１．７％ ，与青年组（９５．８％ ）比较差异有显著性（ Ｐ＜ ０．０５）。激发试验阳性率为 ８４．１％ ，与青年组（７０．１％ ）比较有显著差异（ Ｐ＜ ０．００１）。结论：老年哮喘患者由于基础病变的干扰，使其症状、体征不典型，临床诊断有一定难度。对可疑老年哮喘的病人，应常规行支气管扩张试验，有条件者可作支气管激发试验，以提高老年哮喘的诊断率，以便及时治疗。

Evaluation of the Diagnostic Value of Selective Pulmonary Function Tests for Asthma in the Elderly

Objective: It was designed to evaluate the diagnostic value of selective pulmonary function tests (PFT) for the asthma in the aged. Methods: Selective pulmonary function test, bronchodilator test and bronchial provocation test were performed in 63 cases of clinically diagnosed asthmatics in the elderly and in 113 cases of asthma in young age (<30 year of age) as control group for comparison. Results: Basic value of PEF decreased significantly in asthma of the aged than that of the young group (P<0.05). There was significant difference in bronchodilator test between the old group (81.7%) and the young group (95.8%) (P<0.05). Bronchial provocation test showed significant difference between the old group (84.1%) and the young group (70.1%) (P<0.001). Conclusion: Some of the diseases, mostly COPD, may cause their clinical feature of asthma to be atypical, rendering the diagnoses more difficult. Therefore, in suspected case of asthma in the elderly, routine examination of both bronchodilator test and bronchial provocation test should be performed, preferably the later, in order to benefit the diagnosis of asthma in the elderly.