• 第三軍醫(yī)大學(xué)附屬新橋醫(yī)院全軍呼吸內(nèi)科研究所(重慶 400037);

目的 比較不同嚴重程度COPD患者支氣管舒張試驗中的流速和容積反應(yīng)的差異。方法 回顧性分析217例中度~極重度(Ⅱ~Ⅳ級)COPD患者吸入沙丁胺醇后FEV1和FVC改善的差異。結(jié)果 Ⅱ~Ⅳ級COPD患者在吸入β2受體激動劑后FEV1、FVC均有顯著改善,F(xiàn)EV1和FVC的改善有較大差異。按改變值的大小分段排列,ΔFEV1和ΔFVC(流速和容積反應(yīng))均大致呈正態(tài)分布;其中以ΔFEV1值在0.00~0.04、0.05~0.09和0.10~0.14 L范圍,ΔFVC值在0.00~0.09、0.10~0.19和0.20~0.29 L范圍的患者最多。ΔFEV1在Ⅱ~Ⅳ級COPD患者之間有顯著差異(P lt;0.01),隨嚴重程度增加而降低;ΔFVC表現(xiàn)出與ΔFEV1相反的變化趨勢,隨嚴重程度增加而增加,但在Ⅱ~Ⅳ級COPD患者之間的差異無統(tǒng)計學(xué)意義(P gt;0.05)。不同嚴重程度患者的ΔFEV1和ΔFVC變化趨勢不同,兩者之間仍有顯著的相關(guān)性,但其相關(guān)性隨病情嚴重程度增加而降低。結(jié)論 COPD患者對支氣管舒張劑的流速反應(yīng)和容積反應(yīng)有明顯差異,表現(xiàn)為流速反應(yīng)隨COPD嚴重度增加而顯著降低,容積反應(yīng)則隨嚴重度增加而呈增加。

引用本文: 江漢,張巧,林科雄,趙志強,王金平,王長征. 不同嚴重程度COPD患者吸入支氣管舒張劑后的流速和容積反應(yīng). 中國呼吸與危重監(jiān)護雜志, 2009, 09(2): 110-113. doi: 復(fù)制

1. 趙志強,王金平,王長征.慢性阻塞性肺疾病與支氣管哮喘患者氣道阻塞可逆性的比較.第三軍醫(yī)大學(xué)學(xué)報,2003,25:644-645.
2. Tashkin DP,Celli B,Decramer M,et al. Bronchodilator responsiveness in patients with COPD.Eur Respir J,2008,31:742-750.
3. 張榮葆,何權(quán)瀛,陳青,等.不同劑量的沙丁胺醇對慢性阻塞性肺疾病患者支氣管舒張試驗結(jié)果的影響.臨床內(nèi)科雜,2004,21:322-324.
4. Schermer T,Heijdra Y,Zadel S,et al.Flow and volume responses after routine salbutamol reversibility testing in mild to very severe COPD.Respir Med,2007,101:1355-1362.
5. O’Donnell DE,F(xiàn)orkert L,Webb KA. Evaluation of bronchodilator responses in patients with "irreversible" emphysema.Eur Respir J,2001,18:914-920.
6. GOLD committee.Global Strategy for the Diagnosis,Management and Prevention of COPD(update 2007).Global Initiative for Chronic Obstructive Lung Disease(www.goldcopd.com),2007:3.
7. 宋玉,佟振月,劉剛,等.哮喘病人舒張試驗多項指標的比較及臨床意義.中國醫(yī)科大學(xué)學(xué)報,2003,32:242-243.
8. Puente-Maestu L, García de Pedro J, Martínez-Abad Y,et al.Dyspnea,ventilatory pattern,and changes in dynamic hyperinflation related to the intensity of constant work rate exercise in COPD.Chest,2005,128:651-656.
9. Girard WM,Light RW.Should the FVC be considered in evaluating response to bronchodilator?Chest,1983,84:87-89.
10. Tantucci C,Duguet A,Similowski T,et al.Effect of salbutamol on dynamic hyperinflation in chronic obstructive pulmonary disease patients. Eur Respir J,1998,12:799-804.
11. Soriano JB,Mannino DM. Reversing concepts on COPD irreversibility.Eur Respir J,2008,31:695-696.
  1. 1. 趙志強,王金平,王長征.慢性阻塞性肺疾病與支氣管哮喘患者氣道阻塞可逆性的比較.第三軍醫(yī)大學(xué)學(xué)報,2003,25:644-645.
  2. 2. Tashkin DP,Celli B,Decramer M,et al. Bronchodilator responsiveness in patients with COPD.Eur Respir J,2008,31:742-750.
  3. 3. 張榮葆,何權(quán)瀛,陳青,等.不同劑量的沙丁胺醇對慢性阻塞性肺疾病患者支氣管舒張試驗結(jié)果的影響.臨床內(nèi)科雜,2004,21:322-324.
  4. 4. Schermer T,Heijdra Y,Zadel S,et al.Flow and volume responses after routine salbutamol reversibility testing in mild to very severe COPD.Respir Med,2007,101:1355-1362.
  5. 5. O’Donnell DE,F(xiàn)orkert L,Webb KA. Evaluation of bronchodilator responses in patients with "irreversible" emphysema.Eur Respir J,2001,18:914-920.
  6. 6. GOLD committee.Global Strategy for the Diagnosis,Management and Prevention of COPD(update 2007).Global Initiative for Chronic Obstructive Lung Disease(www.goldcopd.com),2007:3.
  7. 7. 宋玉,佟振月,劉剛,等.哮喘病人舒張試驗多項指標的比較及臨床意義.中國醫(yī)科大學(xué)學(xué)報,2003,32:242-243.
  8. 8. Puente-Maestu L, García de Pedro J, Martínez-Abad Y,et al.Dyspnea,ventilatory pattern,and changes in dynamic hyperinflation related to the intensity of constant work rate exercise in COPD.Chest,2005,128:651-656.
  9. 9. Girard WM,Light RW.Should the FVC be considered in evaluating response to bronchodilator?Chest,1983,84:87-89.
  10. 10. Tantucci C,Duguet A,Similowski T,et al.Effect of salbutamol on dynamic hyperinflation in chronic obstructive pulmonary disease patients. Eur Respir J,1998,12:799-804.
  11. 11. Soriano JB,Mannino DM. Reversing concepts on COPD irreversibility.Eur Respir J,2008,31:695-696.
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