支气管扩张试验后哮喘患者痉挛气道的解痉时相研究

doi:国家自然科学基金资助课题(30070329)

支气管扩张试验后哮喘患者痉挛气道的解痉时相研究

魏剑琴¹，董泽华²，黄瑾^3*，荆伟丽²，尹金植¹，辛秀芹¹

1. 吉林大学第二医院呼吸内科，吉林长春 130041；2. 青岛大学医学院附属医院ICU科，山东青岛266003；3. 中山大学附属第五医院呼吸内科，广东珠海 519000

收稿日期:2005-10-26 修回日期:1900-01-01 出版日期:2006-05-28 发布日期:2006-05-28
通讯作者: 黄瑾

Changes of spasmolysant airways in different phrasesin asthmatic patients after bronchodilation test

WEI Jian-qin¹，DONG Ze-hua²，HUANG Jin^3*，JING Wei-li²，YIN Jin-zhi¹，XIN Xiu-qin¹

1. Department of Respiratory Medicine, Second Hospital, Jilin University, Changchun 130041, China；2. Department of ICU, Affiliated Hospital of Medical College, Qingdao University, Qingdao 266003， China；3. Department of Respiratory Medicine, Fifth Affiliated Hospital, Zhongshan University, Zhuhai 519000, China

Received:2005-10-26 Revised:1900-01-01 Online:2006-05-28 Published:2006-05-28
Contact: HUANG Jin

摘要/Abstract

摘要： 目的：研究哮喘患者痉挛气道的解痉时相线性规律，为哮喘患者的解痉治疗提供理论依据。方法：16例哮喘发作期患者和14例志愿者进行支气管扩张试验，雾化吸入沙丁胺醇后15 min、30 min、1 h、2 h及4 h各个时间点，分别记录FVC、FEV₁、PEF反映大气道功能，以及MMEF、V₅₀、V₂₅反映小气道功能。以志愿者为对照，观察哮喘患者大、小气道解痉时相的差异。建立哮喘患者肺功能指标拟合直线方程，比较拟合直线方程斜率，对哮喘患者大、小气道解痉时相对比分析。结果：在2 h时哮喘患者痉挛的大气道已经达到完全解痉，FVC、FEV₁、PEF与对照组比较差异无显著性。小气道解痉的时间明显滞后，在观察期内各个时间点，除V₅₀外，哮喘患者的MMEF、V₂₅与对照组比较差异有显著性（P<0.05）。FVC、FEV₁、PEF 随时间变化曲线图的拟合直线方程斜率小于0的所占百分比较低；而MMEF、V₅₀、₂₅所占百分比较高（P<0.05）。结论：哮喘患者痉挛的大、小气道解痉时相不同，大气道先解痉，而小气道解痉延迟。临床可针对大气道痉挛为主的患者选用长效或短效药物，而小气道痉挛为主的患者适于选择长效药物。

关键词: 支气管高反应性, 支气管扩张试验

Abstract: Objective To explore the linearic regularity of airways′ spasm and spasmolysis in asthmatic patients, and provide theory bases for clinic treatment.　Methods After regular bronchodilation test, the pulmonary funct ion in 16 asthmatic patients and 14 volunteers were examined 15 min, 30 min, 1 h, 2 h and 4 h later, respectively. The indexes included forced vital capacity (FVC), forced expiratory flow in one second (FEV₁), peak expiratory flow (PEF), maximal midexpiratory flow (MMEF), expiration of 50% FVC (V₅₀) and expiration of 75% FVC (V₂₅) . Results 2 h after bronchodilation test, the big airways dilated completely P<0.05）,while the small airways dilated much later and incom plete except V₅₀. The percentage of indexes including FVC, FEV₁, PEF whose slopes of model straight line were negative was lower. But it was higher to indexes including MMEF, V₅₀ and V₂₅（P<0.05）. Conclusion The big airways dilate first and small ones later af ter given salbutamol. It is helpful for big airways spasm patients to choose the long-acting drugs or short-acting drugs, and for small airways spasm patients the long-acting drugs should be chosen.

Key words: bronchial hyperreactivity, bronchodilation test

中图分类号:

R562.25

魏剑琴，董泽华，黄瑾，荆伟丽，尹金植，辛秀芹. 支气管扩张试验后哮喘患者痉挛气道的解痉时相研究[J]. J4, 2006, 32(3): 493-495.

WEI Jian-qin，DONG Ze-hua，HUANG Jin，JING Wei-li，YIN Jin-zhi，XIN Xiu-qin. Changes of spasmolysant airways in different phrasesin asthmatic patients after bronchodilation test[J]. J4, 2006, 32(3): 493-495.