北京医学
北京醫學
북경의학
BEIJING MEDICAL JOURNAL
2009年
12期
730-734
,共5页
哮喘%可逆性气流受限%支气管舒张试验
哮喘%可逆性氣流受限%支氣管舒張試驗
효천%가역성기류수한%지기관서장시험
Asthma%Reversible airflow obstruction%Bronchial dilation test
目的 采用支气管舒张试验比较发作期和缓解期哮喘患儿气流受限及其可逆性分布特征.方法 对161例哮喘患儿进行支气管舒张试验,雾化吸入速效β_2受体激动剂沙丁胺醇.6岁以上患儿89例(发作期59例,缓解期30例),6岁以下患儿72例(发作期52例,缓解期20例).采用最大呼气流量-容积曲线方法(MEFV)测定6岁以上患儿肺功能,脉冲振荡法(IOS)测定6岁以下患儿肺功能.比较发作期和缓解期患儿气流受限及其可逆性分布特征.结果 依据患儿吸人沙丁胺醇后肺功能参数,分为4种反应类型:可逆性气流受限(基础肺功能异常.舒张试验阳性),不可逆性气流受限(基础肺功能异常,舒张试验阴性),β_2受体激动剂高反应(基础肺功能正常,吸人沙丁胺醇后肺功能变化达到舒张试验阳性标准),β_2受体激动剂低反应(基础肺功能正常.吸入沙丁胺醇后肺功能变化不符合舒张试验阳性标准).发作期哮喘患儿以上4种类型的分布比率分别为36.9%、13.5%、21.6%、27.9%,缓解期患儿4种类型的分布比率分别为22%、12%、16%、50%,两组分布无显著性差异.结论 22%缓解期患儿仍表现为可逆性气流受限特征,提示对这类患儿联合应用β_2受体激动剂可能是必要且有益的.发作期和缓解期患儿在无明显气流受限前提下表现对速效β_2受体激动剂高反应性的原因有待深人研究.
目的 採用支氣管舒張試驗比較髮作期和緩解期哮喘患兒氣流受限及其可逆性分佈特徵.方法 對161例哮喘患兒進行支氣管舒張試驗,霧化吸入速效β_2受體激動劑沙丁胺醇.6歲以上患兒89例(髮作期59例,緩解期30例),6歲以下患兒72例(髮作期52例,緩解期20例).採用最大呼氣流量-容積麯線方法(MEFV)測定6歲以上患兒肺功能,脈遲振盪法(IOS)測定6歲以下患兒肺功能.比較髮作期和緩解期患兒氣流受限及其可逆性分佈特徵.結果 依據患兒吸人沙丁胺醇後肺功能參數,分為4種反應類型:可逆性氣流受限(基礎肺功能異常.舒張試驗暘性),不可逆性氣流受限(基礎肺功能異常,舒張試驗陰性),β_2受體激動劑高反應(基礎肺功能正常,吸人沙丁胺醇後肺功能變化達到舒張試驗暘性標準),β_2受體激動劑低反應(基礎肺功能正常.吸入沙丁胺醇後肺功能變化不符閤舒張試驗暘性標準).髮作期哮喘患兒以上4種類型的分佈比率分彆為36.9%、13.5%、21.6%、27.9%,緩解期患兒4種類型的分佈比率分彆為22%、12%、16%、50%,兩組分佈無顯著性差異.結論 22%緩解期患兒仍錶現為可逆性氣流受限特徵,提示對這類患兒聯閤應用β_2受體激動劑可能是必要且有益的.髮作期和緩解期患兒在無明顯氣流受限前提下錶現對速效β_2受體激動劑高反應性的原因有待深人研究.
목적 채용지기관서장시험비교발작기화완해기효천환인기류수한급기가역성분포특정.방법 대161례효천환인진행지기관서장시험,무화흡입속효β_2수체격동제사정알순.6세이상환인89례(발작기59례,완해기30례),6세이하환인72례(발작기52례,완해기20례).채용최대호기류량-용적곡선방법(MEFV)측정6세이상환인폐공능,맥충진탕법(IOS)측정6세이하환인폐공능.비교발작기화완해기환인기류수한급기가역성분포특정.결과 의거환인흡인사정알순후폐공능삼수,분위4충반응류형:가역성기류수한(기출폐공능이상.서장시험양성),불가역성기류수한(기출폐공능이상,서장시험음성),β_2수체격동제고반응(기출폐공능정상,흡인사정알순후폐공능변화체도서장시험양성표준),β_2수체격동제저반응(기출폐공능정상.흡입사정알순후폐공능변화불부합서장시험양성표준).발작기효천환인이상4충류형적분포비솔분별위36.9%、13.5%、21.6%、27.9%,완해기환인4충류형적분포비솔분별위22%、12%、16%、50%,량조분포무현저성차이.결론 22%완해기환인잉표현위가역성기류수한특정,제시대저류환인연합응용β_2수체격동제가능시필요차유익적.발작기화완해기환인재무명현기류수한전제하표현대속효β_2수체격동제고반응성적원인유대심인연구.
Objective To compare the distribution characteristics of airflow obstruction and its reversibility in children asthma with exacerbation and remission. Methods From April to July 2008, 161 asthmatic children were undertaken the bronchial dilation test after inhaling nebulized salbutamol sulfate solution. These patients included 89 asthmatics older than six years of age (59 cases with exacerbation of asthma, 30 cases with remission of asthma) and 72 asthmatics under six years of age ( 52 cases with exacerbation of asthma, 20 cases with remission of asthma). Pulmonary function were tested by maximal expiratory flow-volume curve (MEFV) for patients older than six years of age and impulse oscillometry (IOS) for patients under six years of age. The distribution characteristics of airflow obstruction and its reversibility in children with exacerbation and remission of asthma were analyzed. Results According to the changes of pulmonary function after inhaling nebulized salbutamol, the bronchial response to beta-2 receptor agonist was classified to four types such as reversible airflow obstruction, irreversible airflow obstruction, hyperresponsiveness to beta-2 receptor agonist, hyporespon-siveness to beta-2 receptor agonist. The rates of these four types in patients with exacerbation of asthma were 36.9%, 13.5%,21.6%, 27.9% and were 22%,12%,16%, 50% in patients with remission of asthma. There was no significant difference on the distribution between the two groups of patients. Conclusions 22% asthmatic children still have reversible airflow obstruction even in remission state, which suggests the necessity and benevolence of beta-2 receptor agonist administration to these patients. The causes of hyperresponsiveness to beta-2 receptor agonist in asthmatic children without obvious airflow obstruction needs further study.
