支气管激发试验和舒张试验在哮喘患者中的应用价值

目的 探究支气管激发试验和舒张试验在哮喘患者中的应用价值.方法 选取2010年6月至2015年3月于我院接受治疗的支气管哮喘患者622例.根据患者基础肺功能及潮气呼吸配合动作,将患者分为激发A组197例、激发B组215例与舒张组210例.对激发A组患者采用Astograph Jupiter-21气道反应仪行乙酰胆碱支气管激发试验,对激发B组患者采用ASP-Pro雾化器行乙酰胆碱支气管激发试验,对舒张组患者行沙丁胺醇支气管舒张试验.观察并比较三组患者的基础肺功能、试验结果阳性与阴性预测值,以及支气管激发两组患者的不良反应情况.结果 舒张组患者年龄为(51.07±16.58)岁,明显高于激发A组及激发B组,差异具有统计学意义(P<0.05);在呼气峰值流速(PEF)、用力肺活量(FVC)、第一秒用力呼气容积(FEV1)占预计值%、FEV1/FVC方面,舒张组基础肺功能较激发A组与激发B组差,差异均具有统计学意义(P<0.05);三组患者在体质量、身高方面比较差异均无统计学意义(P>0.05);舒张组患者的阳性率为76.19%,明显低于激发B组的87.91%与激发A组的86.80%,差异均有统计学意义(P>0.05);激发A组患者的非气道痉挛不良反应率为32.49%,明显高于激发B组的28.84%,差异有统计学意义(P>0.05);激发A组气道痉挛与严重气道痉挛不良反应率分别为2.03%、0,略低于激发B组的2.33%、0.47%,但差异均无统计学意义(P>0.05).结论 支气管激发试验和舒张试验在哮喘患者中的应用价值均较高,有较高阳性预测率、不良反应小,临床应用中应结合FEV1/FVC肺功能指标进行区分.

Application value of bronchial provocation test and diastolic test in patients with asthma

Objective To explore the application value of bronchial provocation test and diastolic test in pa-tients with asthma. Methods A total of 622 patients with bronchial asthma in our hospital from June 2010 to March 2015 were enrolled in the study. Based on the patient's lung function and tidal breathing movements, they were divided into provocation A group (n=197), provocation B group (n=215), and diastolic group (n=210), which received acetylcho-line bronchial provocation test with Astograph Jupiter-21, acetylcholine bronchial provocation test with ASP-Pro atomiz-er, bronchial dilation test with salbutamol, respectively. The basal lung function, positive and negative predictive value, and the adverse reactions of bronchial provocation test were observed. Results The mean age of the patients in diastol-ic group was (51.07 ± 16.58) years, which was significantly higher than that of provocation A group and provocation B group (P<0.05). Diastolic group had significantly worse peak expiratory flow (PEF), forced vital capacity (FVC), FEV1% PRED, FEV1/FVC, diastolic pulmonary function than provocation A group and provocation B group (P<0.05), but no statistically significant difference was found in weight, height (P>0.05). The positive rate of diastolic group was 76.19%, significantly lower than 87.91% in provocation B group and 86.80% in provocation A group (P<0.05). The inci-dence of non-airway spasm in provocation A group was 32.49%, significantly higher than 28.84% in provocation B group (P<0.05). The incidence of airway spasm and severe airway spasm in provocation A group were 2.03%, 0, slightly lower than 2.33%, 0.47% in provocation B group (P>0.05). Conclusion Bronchial provocation test and diastolic test has application value in patients with asthma, with a high positive predictive rate and few adverse reactions, which should be applied combining FEV1/FVC lung function indexes.