CAJ | 학술논문

目的探讨气道反应性与支气管哮喘吸入治疗的关系。方法选择50例支气管哮喘患者作为研究对象，给予吸入沙美特罗氟替卡松50μg/250μg ，每日1～2次，分别在治疗前、治疗后3、6、12个月进行常规肺功能检查和支气管激发试验，测定最大呼气流量（PEF）、1 s用力呼气容积（FEV1）、最大呼气中段流量（MMEF）及比气道传导率下降35％或以上时吸入乙酰甲胆碱浓度（PC35 sGaw ）。结果治疗3个月后大部分患者的临床症状较治疗前有明显改善，PEF、FEV1明显上升，全部病例支气管激发试验仍为阳性；6个月后超过80％的患者哮喘完全控制、肺功能恢复正常，但激发试验阳性病例为38例，达76％；12个月后，超过90％的患者肺功能恢复正常，29例（58％）激发试验阳性。结论哮喘临床症状达到完全控制的时间早于气道反应性达到理想水平的时间，气道反应性指标在调整治疗方案中的价值优于临床症状和肺功能，是评估哮喘的严重程度、药物治疗疗效判断及停药的指标之一。
목적탐토기도반응성여지기관효천흡입치료적관계。방법선택50례지기관효천환자작위연구대상，급여흡입사미특라불체잡송50μg/250μg ，매일1～2차，분별재치료전、치료후3、6、12개월진행상규폐공능검사화지기관격발시험，측정최대호기류량（PEF）、1 s용력호기용적（FEV1）、최대호기중단류량（MMEF）급비기도전도솔하강35％혹이상시흡입을선갑담감농도（PC35 sGaw ）。결과치료3개월후대부분환자적림상증상교치료전유명현개선，PEF、FEV1명현상승，전부병례지기관격발시험잉위양성；6개월후초과80％적환자효천완전공제、폐공능회복정상，단격발시험양성병례위38례，체76％；12개월후，초과90％적환자폐공능회복정상，29례（58％）격발시험양성。결론효천림상증상체도완전공제적시간조우기도반응성체도이상수평적시간，기도반응성지표재조정치료방안중적개치우우림상증상화폐공능，시평고효천적엄중정도、약물치료료효판단급정약적지표지일。
Objective To explore the relationship between airway responsiveness and bronchial asthma inhalation therapy .Meth-ods Select 50 asthmatic patients as research subjects ,Fluorine given inhaled salmeterol 50 mcg/fluticasone propionate 250 micro-grams ,1-2 times a day ,Respectively before treatment ,after treatment ,3 months ,6 months ,12 months ,conventional pulmonary function tests and bronchial provocation test ,Determination of peak expiratory flow (PEF) ,and a second forced expiratory volume (FEV1 ) ,maximum mid-expiratory flow (MMEF) and specific airway conductance decreased 35% or above to inhaled methacholine the concentration(PC35sGaw) .Results Three months after the majority of patients with clinical symptoms before treatment ,after treatment ,significant improvement ,PEF ,FEV1 increased significantly in all cases of bronchial provocation test is still positive ,six months after treatment ,more than 80% of patients with asthma ,complete control ,lung function returned to normal follow-up prov-ocation test positive cases of 38 cases ,up to 76% after 12 months of treatment ,more than 90% of patients with lung function re-turned to normal .29 cases(58% ) stimulation test positive .Conclusion Asthma clinical indicators have reached complete control to achieve the desired level of time earlier than the airway responsiveness ,airway responsiveness index value in the long-term follow-up of the combination therapy ,and adjust the treatment plan is superior to clinical symptoms and lung function ,is a serious assessment of asthmadegree of judgment and withdrawal of drug treatment of one of the indicators .