• 北京協(xié)和醫(yī)院呼吸科(北京 100730);

目的 探討慢性咳嗽患者支氣管激發(fā)試驗前后小氣道功能、氣道阻力及胸外氣道反應(yīng)的狀況。方法 68例慢性咳嗽患者進(jìn)行組胺支氣管激發(fā)試驗,觀察FEV 、呼氣中期流速
(MEF )及吸氣中期流速(MIF硇)的變化,并應(yīng)用強迫振蕩技術(shù)測定激發(fā)前后患者氣道阻力。結(jié)果 支氣管激發(fā)試驗陽性率52% ,激發(fā)陽性患者激發(fā)前MEF50、R0與陰性組患者差異有統(tǒng)計學(xué)意義。MEF50激發(fā)后/激發(fā)前比值(MEF50%)與FEV 激發(fā)后/激發(fā)前比值(FEV1%)呈正相關(guān),與R0激發(fā)前后差值(R0 -d)呈負(fù)相關(guān)。13例患者呈現(xiàn)胸外氣道高反應(yīng)(占總例數(shù)20%),其中6例為單獨存在胸外氣道高反應(yīng),7例患者合并支氣管氣道高反應(yīng)。結(jié)論觀察慢性咳嗽患者小氣道功能變化,有利于對哮喘的及早診治。激發(fā)試驗時聯(lián)合觀察支氣管氣道反應(yīng)和胸外氣道反應(yīng),可為臨床診斷提
供線索。

引用本文: 朱敏立,蔡柏薔. 支氣管激發(fā)試驗在慢性咳嗽病因診斷中的應(yīng)用. 中國呼吸與危重監(jiān)護(hù)雜志, 2008, 08(6): 445-447. doi: 復(fù)制

1. 1 Carney IK,Gibson PG,Murree-Allen K,et al.A systematic evaluation of mechanisms in chronic cough.Am J Respir Crit Mare Med.
2. 陳亞紅,姚婉貞,柳曉芳,等.輕度哮喘患者在支氣管激發(fā)試驗前后小氣道功能及彌散功能的改變.中國呼吸與危重監(jiān)護(hù)雜志,2007,6:3-7.
3. Brightling CE,Ward R,Wardlaw AJ,et al.Airway inflammation,airway responsiveness and cough before and after inhaled budesonide in patients with eosinophilic bronchitis.Eur Resplr J,2000,15:682-686.
4. Christophe D,Hubert L,Martine H,et al.Use of the Forced Oscillation Technique to Assess Airway Obstruction and Reversibility in Children.Am J Respir Crit Care Med,2000,161:730-736.
5. 王志虹,李勇,黃鐵群,等.支氣管激發(fā)試驗在慢性咳嗽診斷中的意義.中國呼吸與危重監(jiān)護(hù)雜志,2007,6:245-248.
6. Bucca C,Rolla G,Scappaticci E,et al.Histamine hyperresponsive- ness of the extrathoracic airw ay in pations with asthmatic symptoms.Allergy,1991,46:147-153.
7. Ribeiro M,Pereira CA,Nery LE,et al.Methacholine 138 adenosine on intra and extrathoracic airway hyperresponsiveness in patients with cough variant asthma.Allergy ,2008,63:527-532.
8. Turktas I,Dalgic N,Bostanci I,et al.Extrathoracic airway respon- siveness in children with asthma-like symptoms,including chronic persistent COUgh.Pediatr Pulmonol,2002,34:172-180. 9 Fernando M,Andrew B.Rhinosinusitis and asthma.Chest,1999, 1 15:550-556.
9. Rolla G,Colagrande P,Magnano M,et al.Extrathoracic airway dys. function in cough associated with gastroesophageal reflux.J Allergy Clin Immunol,1998,102:204-209.
10. Bucca C,Rolla G,Scappaticci E,et al.Extrathoracie and intrathoracic airway responsiveness in sinusitis.J Allergy Clin Immunol,1995,95:52-59.
11. ,156:211-216..
  1. 1. 1 Carney IK,Gibson PG,Murree-Allen K,et al.A systematic evaluation of mechanisms in chronic cough.Am J Respir Crit Mare Med.
  2. 2. 陳亞紅,姚婉貞,柳曉芳,等.輕度哮喘患者在支氣管激發(fā)試驗前后小氣道功能及彌散功能的改變.中國呼吸與危重監(jiān)護(hù)雜志,2007,6:3-7.
  3. 3. Brightling CE,Ward R,Wardlaw AJ,et al.Airway inflammation,airway responsiveness and cough before and after inhaled budesonide in patients with eosinophilic bronchitis.Eur Resplr J,2000,15:682-686.
  4. 4. Christophe D,Hubert L,Martine H,et al.Use of the Forced Oscillation Technique to Assess Airway Obstruction and Reversibility in Children.Am J Respir Crit Care Med,2000,161:730-736.
  5. 5. 王志虹,李勇,黃鐵群,等.支氣管激發(fā)試驗在慢性咳嗽診斷中的意義.中國呼吸與危重監(jiān)護(hù)雜志,2007,6:245-248.
  6. 6. Bucca C,Rolla G,Scappaticci E,et al.Histamine hyperresponsive- ness of the extrathoracic airw ay in pations with asthmatic symptoms.Allergy,1991,46:147-153.
  7. 7. Ribeiro M,Pereira CA,Nery LE,et al.Methacholine 138 adenosine on intra and extrathoracic airway hyperresponsiveness in patients with cough variant asthma.Allergy ,2008,63:527-532.
  8. 8. Turktas I,Dalgic N,Bostanci I,et al.Extrathoracic airway respon- siveness in children with asthma-like symptoms,including chronic persistent COUgh.Pediatr Pulmonol,2002,34:172-180. 9 Fernando M,Andrew B.Rhinosinusitis and asthma.Chest,1999, 1 15:550-556.
  9. 9. Rolla G,Colagrande P,Magnano M,et al.Extrathoracic airway dys. function in cough associated with gastroesophageal reflux.J Allergy Clin Immunol,1998,102:204-209.
  10. 10. Bucca C,Rolla G,Scappaticci E,et al.Extrathoracie and intrathoracic airway responsiveness in sinusitis.J Allergy Clin Immunol,1995,95:52-59.
  11. 11. ,156:211-216..
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