MMEF等小气道指标与非典型哮喘的相关性

目的：探讨小气道指标与非典型哮喘的关系，建立小气道指标预测非典型哮喘的回归方程。方法：对本院呼吸科门诊的612例合并有小气道病变的患者行支气管激发试验检测，比较小气道病变与气道高反应性诊断哮喘的阳性率，用Logistic回归分析建立小气道指标预测非典型哮喘的回归方程。结果：612例小气道病变患者中共有543例支气管激发试验阳性，阳性率为88．73％，其中有531例确诊为哮喘，用气道高反应性诊断哮喘的阳性率为97．79％，用小气道病变预测非典型哮喘的阳性率为86．76％。Logistic回归分析显示：小气道指标MMEF对哮喘的预测价值最高（P〈0．01）。小气道指标预测非典型哮喘的回归方程为：P=Exp（7．486—0．091×MMEF-0．046×FEF50％-0．018×FEF75%）／1＋Exp（7．486—0．091×MMEF-0．046×FEF50%-0．018×FEF75％）]Exp（B）=0．913。结论：小气道指标检测简便易行，适用于我国不能开展支气管激发试验的广泛基层医院，以减少非典型哮喘的漏诊与误诊。

Relevance of MMEF and other small airway parameters in atypical asthma

Objective：To investigate the relevance of small airway parameters in atypical asthma, and to develop a regression equation that predicts atypical asthma using small airway parameters. Methods： total of 612 patients with small airway diseases（SAD） were subjected to bronchial provocation test（BPT）. The incidence of SAD and rate of asthma as indicated by airway hyperresponsiveness were compared. Logistic regression analysis was performed to develop a regression equation for prediction of atypical asthma using small airway parameters. Results：Of the 612 SAD patients, 543 （ 88. 73% ） were positive by BPT, including 531 cases of confirmed asthma. The incidence of atypical asthma was 97.79% as diagnosed with BPT, and 86.76% as predicted by small airway parameters. Logistic regression analysis showed that MMEF was the most valuable predictor for asthma （ P 〈 0. 01 ）. The regression equation for prediction of atypical asthma using small airway parameters was P = Exp （7. 486 - 0. 091 × MMEF - 0. 046 × FEF50% - 0.018 × FEF75% ） / 1 ＋ Exp （ 7. 486-0. 091 × MMEF-0. 046 × FEF50% - 0. 018 × FEF75% ） 1 Exp （B） = 0. 913. Conclusion： Measurement of small airway parameters appears easy and simple, which is useful in community hospitals where BPT are unavailable, to reduce misdiagnosis or under-disgnosis of atypical asthma.