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目的建立慢性阻塞性肺疾病(COPD)和支气管哮喘(以下简称哮喘)支气管舒张反应曲线,探讨COPD和哮喘大、小气道扩张的特点。方法动态观测2004年5月至2005年8月中山大学附属第五医院收治的COPD和哮喘患者吸入福莫特罗前后肺通气功能的变化。结果COPD患者吸入福莫特罗后,第1秒用力呼气量(FEV1)和用力肺活量(FVC)的支气管舒张反应曲线在15min内升高,120min后开始下降,1秒率(FEV1/FVC)支气管舒张反应曲线呈波浪样变化,呼出50%肺活量时最大呼气流量(FEF50)与最大呼气中段流量(FEF75/25)的支气管舒张反应曲线在30min内升高后即开始下降;FEV1,FVC,FEF50随时间点变化的拟合二次曲线模型方程差异有显著性意义(P<0.05)。哮喘患者FEV1,FVC,FEV1/FVC,FEF50,FEF75和FEF75/25的支气管舒张反应曲线在15～30min内升高明显,120min后开始下降;FEV1,FEV1/FVC,FEF75/25随时间点变化的拟合二次曲线模型方程差异有显著性意义(P<0.05)。结论COPD与哮喘患者大、小气道舒张具有不同的特点,支气管舒张反应曲线可以用来鉴别两者。
Objective To establish the bronchial diastolic response curve of chronic obstructive pulmonary disease (COPD) and bronchial asthma (asthma), and discuss the characteristics of large and small airway dilation of COPD and asthma. Methods The changes of pulmonary function before and after inhalation of formoterol in patients with COPD and asthma admitted to the Fifth Affiliated Hospital of Sun Yat-sen University from May 2004 to August 2005 were observed. Results The FEV1 and FVC bronchodilator response curves increased within 15 minutes after COPD patients inhaled formoterol, and then decreased after 120 minutes. The 1 second rate (FEV1 / FVC) The bronchial diastolic response curve showed a wave-like change. The bronchodilator response curve of maximum expiratory flow (FEF50) and maximum expiratory flow (FEF75 / 25) at 50% expiratory volume decreased within 30 minutes. FEV1, FVC , FEF50 changes with time point fitted quadratic curve model difference was significant (P <0.05). The bronchodilator response curve of FEV1, FVC, FEV1 / FVC, FEF50, FEF75 and FEF75 / 25 in asthma patients increased significantly in 15-30 minutes, and then decreased in 120 minutes. FEV1, FEV1 / FVC and FEF75 / 25 changed with time The fitting quadratic curve model equation has significant difference (P <0.05). Conclusion COPD and asthma in patients with large and small airway diastolic have different characteristics, bronchial dilation response curve can be used to identify both.