不同级别慢性阻塞性肺疾病患者对支气管舒张剂的反应

目的: 探讨不同级别的慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者使用支气管舒张剂后的反应性差异。方法: 回顾性分析220例COPD患者，按病情程度分为Ⅰ~Ⅳ级，吸入支气管舒张剂沙丁胺醇后，分别比较肺功能流速指标1秒最大呼气容积(FEV1)与容量指标用力肺活量(FVC)的改变值。结果： 支气管舒张后，COPD患者的FEV1与FVC均较试验前有不同程度增加(P均<0.01)。Ⅰ~Ⅳ级COPD患者在吸入β2受体激动剂后FEV1、FVC均有显著改善。按改变值的大小分段排列，Ⅰ~Ⅱ级COPD患者ΔFEV1较Ⅲ~Ⅳ级患者改善明显(P<0.01)；Ⅲ~Ⅳ级COPD患者ΔFVC较Ⅰ~Ⅱ级改善明显(P<0.01)。结论： 不同级别COPD患者在使用支气管舒张剂后，流速与容量均得以改善。FEV1可作为Ⅰ~Ⅱ级COPD患者对支气管舒张试验反应的重要指标，FVC可作为Ⅲ~Ⅳ级COPD患者对支气管舒张试验的重要指标。

Response to bronchodilator in patients with different severity chronic obstructive pulmonary disease

Objective: To evaluate the differences of flow and volume responses in patients with mild to severe chronic obstructive pulmonary disease (COPD) in bronchodilatation test. Methods: The different changes of forced expiratory volume in one second（FEV1）and forced vital capacity（FVC） in 220 patients over sixty year old with mild to very severe COPD (GOLD stageⅠ Ⅳ) were analyzed retrospectively after inhaling salbutamol. Results: After inhaling β2 agonist, FEV1 and FVC of the patients with COPD at stageⅠ Ⅳ increased remarkably, there were significant differences in the changes of FEV1 and FVC between patients with COPD compared with before treatment (P<0.01)．ΔFEV1 at stage Ⅰ Ⅱpatients with COPD increased more obviously than stage Ⅲ Ⅳ patients with COPD (P<0.01); on the contrary,ΔFVC at stage Ⅲ-Ⅳ patients with COPD improved more markedly than stage Ⅰ Ⅱ patients with COPD (P<0.01). Conclusion: There were differences between post bronchodilator flow and volume responses in patients with COPD at different stage．The reversibility of stage Ⅰ Ⅱ patients with COPD could be evaluated by FEV1, while stage Ⅲ Ⅳ patients with COPD could be evaluated by FVC.