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征对比研究

发布时间：2018-11-07 07:54

【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。方法纳入呼吸内科门诊主诉呼吸困难的患者148例,其中非器质性呼吸困难和支气管哮喘患者各74例进行调查,确定非器质性呼吸困难和支气管哮喘的诊断标准,对两组患者进行医院焦虑抑郁量表、Nijmegen症状学问卷和阿森斯失眠量表进行自我评估调查,收集两组患者的躯体化症状、有效睡眠时间和肺功能检查情况并作对比分析。结果两组患者都可以出现全身症状,非器质性呼吸困难多以心因性症状为主要表现。非器质性呼吸困难组的有效睡眠时间要少于支气管哮喘组(P0.05),非器质性呼吸困难组焦虑评分、抑郁评分、Nijmegen问卷评分、阿森斯失眠量表评分、第1秒用力呼气容积(forced expiratory volume in one second,FEV1)、第1秒用力呼气容积占预计值的百分比(forced expiratory volume in one second/predict value,FEV1%Pred)、用力肺活量占预计值的百分比(forced vital capacity/predict value,FVC%Pred)、第1秒用力呼气容积与用力肺活量的比值(forced expiratory volume in one second/forced vital capacity,FEV1%FVC)均明显高于支气管哮喘组,差异均有统计学意义(P0.05),而用力肺活量(forced vital capacity,FVC)两组无统计学差异。结论非器质性呼吸困难更侧重于精神心理方面的症状。非器质性呼吸困难的焦虑、抑郁、失眠要比支气管哮喘更加明显。遇到呼吸困难患者就诊时,在鉴别非器质性呼吸困难和支气管哮喘时,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,避免医疗资源的浪费。
[Abstract]:Objective to investigate and compare the clinical features of non-organic dyspnea and bronchial asthma. Methods 148 patients with dyspnea were included in the department of respiratory medicine, including 74 cases of non-organic dyspnea and 74 cases of bronchial asthma. The diagnostic criteria of non-organic dyspnea and bronchial asthma were determined. The hospital anxiety and depression scale, Nijmegen symptom questionnaire and Ascension Insomnia scale were used to evaluate the symptoms of somatization, effective sleep time and pulmonary function in the two groups. Results systemic symptoms were found in both groups, and psychogenic symptoms were the main manifestation of non-organic dyspnea. The effective sleep time in non-organic dyspnea group was less than that in bronchial asthma group (P0.05), anxiety score, depression score, Nijmegen questionnaire score and Ascension insomnia scale score in non-organic dyspnea group. Forced expiratory volume (forced expiratory volume in one second,FEV1), forced expiratory volume (forced expiratory volume in one second/predict value,FEV1%Pred), forced expiratory volume (forced expiratory volume in one second/predict value,FEV1%Pred), forced vital capacity (forced vital capacity/predict value,) FVC%Pred), the ratio of forced expiratory volume to forced vital capacity (forced expiratory volume in one second/forced vital capacity,FEV1%FVC) in the 1st second was significantly higher than that in the asthma group (P0.05), while the forced vital capacity (forced vital capacity,) was significantly higher than that in the asthma group (P0.05). FVC) there was no statistical difference between the two groups. Conclusion non-organic dyspnea is more focused on psycho-psychological symptoms. Anxiety, depression, and insomnia are more pronounced in non-organic dyspnea than in bronchial asthma. In distinguishing non-organic dyspnea from bronchial asthma, the clinician should pay attention to the inquiry of the related medical history, such as emotion, sleep, somatization and other symptoms, perform pulmonary function examination, and recognize the clinical characteristics of the two. To reduce the rate of missed diagnosis and misdiagnosis, to avoid the waste of medical resources.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R562.25

【相似文献】