典型哮喘与咳嗽变异性哮喘的小气道功能差异分析

发布时间：2018-03-07 20:48

本文选题：典型哮喘　切入点：咳嗽变异性哮喘　出处：《南方医科大学学报》2017年03期 　论文类型：期刊论文

【摘要】：目的对比典型哮喘、咳嗽变异性哮喘(CVA)患者的小气道功能指标及临床特征差异,为延缓咳嗽变异性哮喘向典型哮喘进展提供依据。方法 43例初诊哮喘患者分为典型哮喘激发试验阳性组(TA BPT(+),n=15)、典型哮喘舒张试验阳性组(TA BDT(+),n=12)和咳嗽变异性哮喘组(CVA,n=16);以同时段27例健康体检者为对照组。受试者进行资料采集、哮喘控制测试、哮喘测试控制量表、呼出气一氧化氮、脉冲震荡气道阻力检查、肺通气功能检查,支气管激发试验或舒张试验。结果 TA BDT(+)起病至明确诊断间隔时间最长、TA BPT(+)次之、CVA最短(P=0.022)。TA BDT(+)肺通气功能指标明显低于TA BPT(+)、CVA、对照组(均P0.05);TA BDT(+)、TA BPT(+)、CVA患者最大呼气中期流速、75%、50%、25%肺活量时最大呼气流速均较对照组低(P0.01)。TA BDT(+)患者响应频率、呼吸总阻抗、总气道阻力、中心气道阻力、外周气道阻力、外周弹性阻力较对照组高(P0.05),而TA BPT(+)、CVA与对照组无统计学差异。TA BPT(+)、CVA、对照组激发试验前后气道阻力指标升高,气道阻力指标改变量TA BPT(+)最大,CVA次之。CVA患者呼出气一氧化氮与呼吸总阻抗、总气道阻力、中心气道阻力呈强正相关性(r=0.523,0.542,0.524,P=0.038,0.030,0.037),气道反应性与中心气道阻力呈强正相关性(ρ=-0.512,P=0.043)。结论 CVA是TA的早期阶段,推测CVA、TA BPT(+)、TA BDT(+)是哮喘的不同阶段。当CVA未控制可发展为TA BPT(+);继续进展可出现气道功能改变及肺功能损害,可能发展为TA BDT(+)。
[Abstract]:Objective to compare the small airway function and clinical features of patients with typical asthma and cough variant asthma (CVA). Methods 43 newly diagnosed asthmatic patients were divided into three groups: TABPT15 group, TABDT12 group and cough variant asthma group. In asthmatic group, CVANM 16, and 27 healthy persons as control group at the same time. The data were collected from the subjects. Asthma control test, asthma test control scale, exhalation nitric oxide, pulse concussion airway resistance test, pulmonary ventilation function test, Results the longest diagnostic interval between TA BDT() and definite diagnostic interval (TABPTT) was lower than that of TABPTA (0.022). TABDT() pulmonary ventilation function was significantly lower than that of TABPTA, and that of control group (all P0.05) was the highest in patients with TA BDT- (TTA BDTT). The maximum expiratory flow rate at 25% vital capacity was lower than that in the control group, and the response frequency of the patients was lower than that of the control group. Total respiratory impedance, total airway resistance, central airway resistance, peripheral airway resistance and peripheral elastic resistance were significantly higher than those in control group (P 0.05). The change of airway resistance index (TABPT()) was the highest in CVA patients, followed by exhalation nitric oxide and total respiratory resistance, total airway resistance. There was a strong positive correlation between central airway resistance and central airway resistance. Conclusion CVA is the early stage of TA, and there is a strong positive correlation between airway reactivity and central airway resistance. It is inferred that CVA TA BPT (TTA BDT()) is a different stage of asthma. If CVA is not controlled, it may develop into TABPTT; if CVA is not controlled, airway function changes and lung function damage may occur, and it may develop to TA BDT(?).
【作者单位】：南方医科大学珠江医院呼吸内科;
【基金】：广东省科技计划项目(2014A020212395)
【分类号】：R562.25

【相似文献】