支气管激发试验在夜间发作性喘息病因诊断中应用.docVIP

支气管激发试验在夜间发作性喘息病因诊断中应用 　　[摘要] 目的 探讨夜间发作性喘息患者支气管激发试验前后第1秒用力呼气量（FEV1）、呼气中期流速（FEF50）的反应状况。 方法 84例夜间发作性喘息患者进行乙酰甲胆碱支气管激发试验，观察FEV1、FEF50的变化。 结果 支气管激发试验阳性率33％，阳性组患者激发前FEV1（2.88±0.62），激发后FEV1（2.18±0.47），两者之间比较差异具有统计学意义（P＜0.01），59例患者呼气中期流速（FEF50）在激发后下降＞20％。激发试验后FEF50下降与FEV1下降呈明显正相关性。 结论 夜间发作性喘息患者的病因常为支气管哮喘，而患者肺功能在白天可以恢复正常，观察患者激发前后FEV1变化，有利于对哮喘的正确诊断。 　　[关键词] 夜间发作性喘息；支气管哮喘；支气管激发试验 　　[中图分类号] R562.2+5 [文献标识码] B [文章编号] 1673-9701（2012）02-0043-02 　　 　　Application of bronchial provocation test in etiological diagnosis of night gasping 　　CHEN Zhongbo YU Yiming CAO Chao DING Qunli LV Dan MA Hongying SUN Shifang SHU Lihua DENG Zaichun 　　Department of Respiratory, the Affiliated Hospital of Medical School of Ningbo University, Ningbo 315020, China 　　[Abstract] Objective To investigate the changes of FEV1 and FEF50 in night gasping patients before and after bronchial provocation test (BPT)． Methods All of 84 night gasping patients were enrolled to conduct lung function test and BPT. Results Airway hyperresponsiveness was found in 33％ subjects based on BPT. There was significant statistical differences between patients with airway hyperresponsiveness and without airway hyperresponsiveness in the FEV1 and FEF50 at baseline． In positive group, Pre-BPT testing FEV1(2.88±0.62), post BPT testing FEV1(2.18±0.47), P＜0.01；Post of BPT testing, 20% fall in FEF50 was found in 59 patients. Post BPT changes in FEF50 (FEF50％) were correlated positively to the changes in FEV1 (FEV1％). Conclusion Usually, night gasping etiology is the cause of asthma, and lung function in those patients daytime maybe normal. Our findings support the possible role of BPT in the diagnosis of asthma among patients with night gasping. 　　[Key words] Night gasping；Bronchial Athma; Bronchial provocation test 　　 　　支气管哮喘患者中有很大一部分在夜间起病，表现为夜间发作喘息、胸闷，伴或不伴咳嗽，而日间症状不明显，甚至完全消失，给临床诊治带来困难。由于常规肺通气功能检查不能有效鉴别出此类患者，临床上常通过支气管激发试验进行辅助诊断。本文对84例夜间发作性哮喘患者乙酰甲胆碱支气管激发试验结果进行分析，旨在探讨激发试验在夜间发作性喘息病因诊断中的作用。 　　 　　1 资料与方法 　　1.1 一般资料 　　2007年7月