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目的探讨慢性咳嗽患者小气道病变与气道高反应性的相关性及其对早期哮喘的预测价值。方法对广东省中医院呼吸科2004年9月至2006年9月就诊的249例慢性咳嗽患者,用肺功能检测判断有无小气道病变,用支气管激发试验检测其气道反应性;进一步分析小气道病变与气道高反应性之间的相关性及与患者年龄之间的关系。结果249例慢性咳嗽患者中91例有小气道病变,103例患者支气管激发试验阳性;有小气道病变患者的支气管激发试验阳性率(73.63%,67/91)较无小气道病变患者(22.78%,36/158)明显增高,差异有显著性意义(P<0.01)。小气道病变患者中,<40岁组的激发试验阳性率(90.0%,27/30)明显高于≥40岁组(65.57%,40/61),差异有显著性意义(P<0.05)。结论小气道病变是气道高反应性患者的重要特征,可以用来发现早期年轻哮喘患者。
Objective To investigate the correlation between small airway lesions and airway hyperresponsiveness in chronic cough and its predictive value for early asthma. Methods 249 cases of chronic cough treated by Department of Respiratory Medicine, Guangdong Provincial Hospital of Traditional Chinese Medicine from September 2004 to September 2006 were evaluated with pulmonary function test to determine the presence or absence of small airway disease. Bronchial provocation test was used to detect airway reactivity. Correlation between pathological changes and airway hyperresponsiveness and their relationship to patient age. Results Of the 249 patients with chronic cough, 91 had small airway disease and 103 had bronchial provocation test positive. The positive rate of bronchial provocation test in patients with small airway disease (73.63%, 67/91) was significantly higher than that in patients without small airway disease (22.78% , 36/158) was significantly higher, the difference was significant (P <0.01). In patients with small airway disease, the positive rate of the challenge test in the group <40 years old was significantly higher than that in the group ≥40 years old (90.0%, 27/30) (65.57%, 40/61) (P <0.05). Conclusions Small airway disease is an important characteristic of patients with airway hyperresponsiveness and can be used to detect early-stage asthma in young patients.