支气管激发试验预测支气管哮喘患者治疗的远期预后分级

发布时间：2018-05-15 19:23

本文选题：支气管哮喘 + 支气管激发试验　；参考：《中国全科医学》2015年08期

【摘要】：目的探讨支气管激发试验评估气道反应敏感性是否可以对支气管哮喘患者经糖皮质激素治疗的远期预后进行分级。方法选取2007—2009年白银市第一人民医院符合支气管哮喘诊断标准的支气管哮喘患者173例,按照不同药物激发浓度出现气道高反应性阳性,将患者分为10组,分别为乙酰甲胆碱吸入剂量0.030μmol组、0.060μmol组、0.125μmol组、0.250μmol组、0.500μmol组、1.000μmol组、2.000μmol组、4.000μmol组、6.000μmol组、8.000μmol组。患者均行标准支气管哮喘糖皮质激素吸入治疗方案:舒利迭(沙美特罗/丙酸氟替卡松50/250μg,2次/d,持续3个月)。分别于治疗后6个月及1、2、3年复查支气管激发试验,评估治疗后气道高反应阳性率。结果各组患者性别、年龄、病程比较,差异均无统计学意义(χ2性别=1.615,F年龄=0.385,F病程=0.533,P0.05)。随访6个月及1、2、3年时,不同组别复发率比较,差异均有统计学意义(P0.05)。在不同组别复发率下降过程中,出现3个较为明显的平台期,即0.030~0.250μmol、0.500~4.000μmol、6.000~8.000μmol。结论气道反应的敏感性可以对支气管哮喘糖皮质激素治疗患者远期预后进行分级,即乙酰甲胆碱吸入浓度在0.030~0.250μmol为高度复发可能患者(40%),吸入浓度在0.500~4.000μmol为中度复发可能患者(30%~35%),吸入浓度在6.000~8.000μmol为低度复发可能患者(20%)。
[Abstract]:Objective to investigate whether bronchial provocation test can grade the long-term prognosis of bronchial asthma patients treated with glucocorticoid. Methods 173 patients with bronchial asthma who met the diagnostic criteria of bronchial asthma in the first people's Hospital of Baiyin City from 2007 to 2009 were divided into 10 groups. The inhaled dose of methacholine was 0.030 渭 mol, 0.060 渭 mol, 0.125 渭 mol, 0.250 渭 mol, 1.000 渭 mol, 2.000 渭 mol, 4.000 渭 mol, 6.000 渭 mol, 8.000 渭 mol, respectively. All patients were treated with standard bronchial asthma glucocorticoid inhalation regimen: sumeterol / fluticasone propionate 50 / 250 渭 g / d for 3 months. Bronchial provocation test was reexamined at 6 months and 1 to 2 years after treatment to evaluate the positive rate of airway hyperresponsiveness. Results there was no significant difference in sex, age and course of disease among the three groups (蠂 ~ 2 / 1. 615F age = 0.385 / F). At 6 months, 1 and 2, 3 years, the recurrence rates of different groups were significantly different (P 0.05). During the decline of recurrence rate in different groups, there were three obvious plateau periods, namely, 0.030 ~ 0.250 渭 mol / L 0.500 渭 mol / L 4.000 渭 mol / L 6.000 渭 mol / L ~ 8.000 渭 mol / L. Conclusion the sensitivity of airway reaction can be used to grade the long-term prognosis of patients with bronchial asthma treated with glucocorticoid. That is to say, the concentration of methacholine inhalation was 0.030 渭 mol 0.250 渭 mol for the patients with high risk of recurrence, 0.500,4.000 渭 mol for the patients with moderate recurrence, and 6.000 渭 mol for the patients with moderate recurrence. The inhaled concentration of acetylcholine was 8.000 渭 mol for the patients with low recurrence.
【作者单位】：甘肃省白银市第一人民医院;
【分类号】：R562.25

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