- 期刊
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支氣管反應性和肺通氣功能之間的關係
Relationship between Bronchial Hyperresponsiveness and Pulmonary Function
摘要
支氣管反應性增加是支氣管氣喘的特徵，和病情的輕重密切相關。支氣管氣喘患者在非發作期間，其通氣管能與支氣管反應性之間的關係各個報告的結果和意見不一。本文對139例青年支氣管氣喘病患者（非急性發作期）和20例正常青年人進行了通氣功能測定，並用甲基膽素（methacholine）吸入激發試驗測定支氣管反應性，以確定在不發作期通氣功能與反應性之間的關係，並分析其在診斷和病情分析上的價值，支氣管反應性以PD40表示之即使氣道傳導性（SGaw）下降40%所需之激發劑量（provocation dose）。我們發現雖然通氣功能和PD40之間有一定的相關關係，隨著反應性增加的加重，通氣功能有逐漸下降的趨勢；但是各組之間的結果非常離散，有嚴重相互重疊現象；而且反應性輕度甚至中度增高的患者其通氣功能平均值可能仍在正常範圍。以FEV1（第1秒用力呼氣量）為例，FEV1實測值占預計值%的平均值在反應性輕度和中度增加的患者均超過80%，而FEV1占預計值80%以下時才有診斷意義。所以我們認為在不發作期間的通氣功能通氣結果僅可作為診斷之參考，應結合病史及支氣管反應性的測定進行綜合考慮。
並列摘要
Bronchial hyperresponsiveness is one of the characteristic features of bronchial asthma and closely reflects the severity of asthma. The controversies still exist in the literature concerning relationship between the degree of bronchial hyperresposinveness and pulmonary function. In this study, 139 asymoptomatic asthma subjects and 20 normal controls received both pulmonary function and methacholine provocation tests for determining the relationship between bronchial hyperresponsiveness and pulmonary function. At the same time we also evaluate the role of the two tests for diagnosis of asthma. Bronchial hyperresponsiveness was expressed as PD40 (provocation dose) that produced a 40% reduction in predicted SGaw. We found that subjects with greater detree of bronchial hyperresponsiveness have worse pulmonary function than those with a less degree of bronchial hyperresponsiveness, but the result of each group was diverse and severely-overlapping. The mild and moderate bronchial hyperresponsiveness may have normal pulmonary function. For example, the means of FEV1 in the mild and moderate bronchial hyperresponsiveness in our study were over 80% predicted value. But diagnostic value of asthma only depended on FEV1 less than 80% predicted value. In conclusion, we though the pulmonary function in asymptomatic asthma should not be relied. The diagnosis of asthma should include history and bronchial hyperresponsiveness test.