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目的探讨动态肺量测定技术在支气管哮喘中的应用。方法建立动态肺量测定技术,对20例支气管哮喘患者每天清晨、下午和入睡前连续14d动态监测气道功能、症状和情绪。结果白天标准肺功能检查结果正常的支气管哮喘患者,第一秒用力呼气量(FEV1)和最大呼气峰流量(PEF)在夜间和凌晨可出现明显下降。肺功能指标与支气管哮喘症状的相关分析发现,只有7例患者(35%)支气管哮喘症状与FEV1和PEF存在相关关系。4例患者(20%)肺功能基本正常,但有很多症状,症状与FEV1和PEF无相关关系,但与负面情绪相关。另外2例患者(10%)肺功能损害严重,但几乎没有症状。结论动态肺量测定技术能客观反映支气管哮喘患者气道功能的昼夜自然变化,因此可以更准确地反映支气管哮喘的严重程度。动态肺量测定技术结合症状和情绪的同步监测,可以帮助识别出特殊症状感觉类型的支气管哮喘患者。
Objective To investigate the application of dynamic spirometry in bronchial asthma. Methods Dynamic spirometry was established in 20 patients with bronchial asthma, and the airway function, symptoms and mood were monitored dynamically every morning, afternoon and before falling asleep for 14 consecutive days. Results In patients with normal bronchial asthma who had normal pulmonary function tests during the day, FEV1 and PEF decreased significantly at night and in the early hours. Correlation analysis of pulmonary function parameters and bronchial asthma symptoms found that only 7 patients (35%) had bronchial asthma symptoms correlated with FEV1 and PEF. Four patients (20%) had normal lung function but many symptoms, which were not associated with FEV1 and PEF, but were associated with negative emotions. The other 2 patients (10%) had severe lung function damage but almost no symptoms. Conclusions Dynamic spirometry can objectively reflect the diurnal changes of airway function in patients with bronchial asthma, so it can reflect the severity of bronchial asthma more accurately. Dynamic spirometry, combined with the simultaneous monitoring of symptoms and mood, can help identify patients with bronchial asthma that have a particular symptomatic sensory type.