以呼吸困难为主诉的非器质性呼吸困难与支气管哮喘临床特点对比研究

发布时间：2018-03-26 06:40

本文选题：呼吸困难　切入点：支气管哮喘　出处：《上海交通大学学报(医学版)》2017年07期

【摘要】：目的·调查并对比分析以呼吸困难为主诉的非器质性呼吸困难和支气管哮喘的临床特征。方法·连续入选呼吸科门诊因呼吸困难就诊的性别与年龄相匹配、身高与体质量相接近的非器质性呼吸困难和支气管哮喘患者各74例作为调查对象,对2组患者行医院焦虑抑郁量表、Nijmegen症状学问卷和阿森斯失眠量表问卷调查,收集2组患者的症状描述语、临床症状、有效睡眠时间和肺功能指标并作对比分析。结果·非器质性呼吸困难组倾向于精神心理方面的描述,支气管哮喘组侧重于气流受限的描述。非器质性呼吸困难组多以心因性症状为主要表现,且睡眠时间少于支气管哮喘组(P0.05);焦虑评分、抑郁评分、Nijmegen评分、阿森斯失眠问卷评分、第1秒用力呼气容积、第1秒用力呼气容积占预计值的百分比、用力肺活量占预计值的百分比、一秒率均大于支气管哮喘组,差异均有统计学意义(P0.05);用力肺活量2组差异无统计学意义(P0.05)。结论·非器质性呼吸困难组的焦虑、抑郁、失眠比支气管哮喘组更加明显,支气管哮喘组肺功能大多存在异常。鉴别两者时,临床医师需重视情绪、睡眠、躯体化症状等相关病史的询问,行肺功能检查,认识两者的临床特点,降低漏诊率及误诊率。
[Abstract]:Objective to investigate and compare the clinical characteristics of non-organic dyspnea and bronchial asthma, which were complained of dyspnea. A total of 74 patients with non-organic dyspnea and 74 patients with bronchial asthma with similar height and body mass were investigated. Two groups of patients were investigated with the hospital anxiety and depression scale Nijmegen symptom questionnaire and Ascension Insomnia scale. The symptom description language, clinical symptoms, effective sleep time and pulmonary function were collected and compared between the two groups. Results the non-organic dyspnea group tended to describe psychologically. The bronchial asthma group focused on the description of airflow limitation. The non-organic dyspnea group was mainly characterized by psychogenic symptoms, and the sleep time was less than that in the bronchial asthma group (P 0.05); anxiety score, depression score and Nijmegen score; Ascension Insomnia scale; The forced expiratory volume in the 1st second, the percentage of the forced expiratory volume in the predicted value in the first second, the percentage of forced vital capacity in the predicted value in the first second group were higher than those in the bronchial asthma group. There was no significant difference in forced vital capacity between the two groups. Conclusion the anxiety, depression and insomnia in non-organic dyspnea group are more obvious than those in bronchial asthma group. When differentiating between the two groups, clinicians should pay attention to the inquiry of related medical history, such as emotion, sleep, somatization, etc., check the lung function, recognize the clinical characteristics of both, and reduce the rate of missed diagnosis and misdiagnosis.
【作者单位】：重庆医科大学附属第一医院呼吸与危重症医学科;
【基金】：国家自然科学基金(81570010) 国家临床重点专科专项经费资助项目(2012-649)~~
【分类号】：R562.25

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