论文部分内容阅读
目的 探讨乙酰甲胆碱激发试验气道敏感性与反应性测定的临床意义与诊断价值。方法 对 2 5例支气管哮喘 (简称哮喘 )、2 7例咳嗽变异型哮喘 (简称咳型哮喘 )、48例慢性支气管炎患者 (其中激发试验阳性者 11例 )及 10例健康人作乙酰甲胆碱激发试验 ,分别绘出剂量—反应曲线 ,计算出气道敏感性 (用 s Gaw下降 35 %时乙酰甲胆碱的浓度 ,PC35 s Gaw表示 )和反应性 (阳性反应后剂量—反应曲线的斜率 ,即 K表示 )。结果 健康人及大部分 (37/ 48)慢性支气管炎患者的剂量—反应曲线达到高峰后 ,SGaw下降仍低于 35 % ,哮喘和咳型哮喘患者的剂量—反应曲线随乙酰甲胆碱浓度的增高而呈上升趋势 ,s Gaw下降高于 35 % ;气道敏感性依次为 :哮喘 >咳型哮喘 >慢性支气管炎 ;气道反应性依次为 :哮喘≈咳型哮喘 >慢性支气管炎。结论 气道的敏感性与反应性不完全平行。这两项测定对哮喘的诊断及治疗效果的评定具有重要临床价值。
Objective To investigate the clinical significance and diagnostic value of methacholine provocation test on airway sensitivity and reactivity. Methods Twenty-five cases of bronchial asthma (asthma), 27 cases of cough variant asthma (asthma cough type), 48 cases of chronic bronchitis (including 11 cases of provocation test positive) and 10 cases of healthy people as acetylcholine Alkalotic challenge test, dose-response curves were plotted separately and the airway sensitivity (methacholine concentration at 35% reduction with s Gaw, PC 35 s Gaw) and reactivity (slope of the dose-response curve after positive reaction , That is K). Results After the dose-response curve peaked in healthy individuals and in most (37 of 48) patients with chronic bronchitis, the SGaw decreased still below 35%, and the dose-response curves for asthmatic and cough-type asthmatics varied with methacholine concentrations SGaw decreased by more than 35%. The airway sensitivities were as follows: asthma> cough-type asthma> chronic bronchitis; airway reactivity were as follows: asthma ≈ cough-type asthma> chronic bronchitis. Conclusion Airway sensitivity and reactivity are not completely parallel. These two tests have important clinical value in the diagnosis of asthma and the evaluation of the therapeutic effect.