【摘要】：目的:觀察支氣管激發(fā)試驗(yàn)陽性的支氣管哮喘患者大小氣道指標(biāo)的改變,并探討FEV1、PEF指標(biāo)與小氣道下降率的相關(guān)性。方法:對(duì)行激發(fā)試驗(yàn)(BPT)為陽性70例支氣管哮喘患者進(jìn)行回顧性分析,根據(jù)基礎(chǔ)肺功能MMEF分為A、B兩組,A組為MMEF≥80%,B組MMEF80%。觀察其大氣道FEV1、PEF、FEF75%、FEF50%、MMEF在激發(fā)前后、治療前后的變化及FEV1、PEF與小氣道指標(biāo)的相關(guān)性。結(jié)果:1.A、B兩組在年齡(歲)、身高(cm)、體重(kg)方面的差異是無統(tǒng)計(jì)學(xué)意義,P0.05。2.PEF異常率明顯高于FEV1、FEF75%、FEF50%、MMEF異常率。3.A組與B組比較,在激發(fā)前、激發(fā)后的FEV1%pre、PEF%pre、FEF75%pre、FEF50%pre的變化的差異有統(tǒng)計(jì)學(xué)意義,均明顯高于B組,P0.001。4.A、B兩組中大小氣道指標(biāo)下降率(FEV1下降率、PEF下降率、FEF75下降率、FEF50下降率、MMEF下降率)相互之間是有明顯差異的(P0.05),小氣道指標(biāo)下降率明顯高于大氣道指標(biāo)下降率。A、B兩組FEV1下降率、PEF下降率、FEF75下降率、MMEF下降率、FEF50下降率相比較之間存在的差異是沒有統(tǒng)計(jì)學(xué)意義(P0.05)。5.A、B兩組FEF75%、FEF50%、MMEF下降率與FEV1下降率之間的差異有統(tǒng)計(jì)學(xué)意義(P0.05)。6.A組FEF75%、FEF50%、MMEF下降率分別與PEF下降率之間的差異無統(tǒng)計(jì)學(xué)意義(P0.05)。B組小氣道指標(biāo)FEF50%、MMEF下降率與PEF下降率之間的差異無統(tǒng)計(jì)學(xué)意義(P0.05),FEF75下降率與PEF下降率之間有顯著差異(P0.05)。7.FEV1、PEF下降率與FEF75、FEF50、MMEF下降率呈正相關(guān)(P0.001)。但年齡(歲)與小氣道指標(biāo)FEF75%、FEF50%、MMEF下降率之間不存在相關(guān)性,無統(tǒng)計(jì)學(xué)意義(P0.05)。8.A、B兩組經(jīng)治療后PEF、FEF75%、FEF50%、MMEF指標(biāo)明顯改善。結(jié)論:支氣管哮喘患者小氣道具有很高的敏感性,明顯高于大氣道。小氣道功能異常的患者和小氣道功能正�；颊咴谀挲g方面的差異是沒有統(tǒng)計(jì)學(xué)意義的。小氣道功能正常組與小氣道功能異常組的哮喘患者各大小氣道指標(biāo)的下降率之間有明顯差異,但兩組比較差異無統(tǒng)計(jì)學(xué)意義。大小氣道之間存在正相關(guān)。小氣道功能異常對(duì)哮喘的臨床上有很大的影響,所以監(jiān)測(cè)小氣道指標(biāo)對(duì)早期診斷、及時(shí)預(yù)防哮喘及評(píng)估哮喘療效有很重要的意義。
[Abstract]:AIM: To observe the changes of airway parameters in bronchial asthma patients with positive bronchial provocation test (BPT), and to explore the correlation between FEV1, PEF and the decrease rate of small airway. The changes of airway FEV1, PEF, FEF 75%, FEF 50% and the correlation between FEV1, PEF and small airway parameters were observed before and after stimulation. Results: 1. There was no significant difference in age (age), height (cm) and weight (kg) between group A and group B, P 0.05.2. The abnormal rate of PEF was significantly higher than that of FEV1, FEF 75%, FEF 50%, and abnormal rate of MMEF. Compared with group B, the changes of FEV1% pre, PEF% pre, FEF75% pre, FEF50% pre before and after stimulation were statistically significant, which were significantly higher than those of group B (P 0.001.4.A). There were significant differences in the decrease rates of airway parameters (FEV1, PEF, FEF75, FEF50, MMEF) between two groups (P 0.05). The decrease rate of FEV1, PEF, FEF75, MMEF and FEF50 in group B was significantly higher than that in group B (P There was no significant difference between the decrease rate of FEF, FEF 50%, MMEF and PEF in group B (P 0.05). There was no significant difference between the decrease rate of MMEF and the decrease rate of PEF (P 0.05). There was significant difference between the decrease rate of FEF 75 and the decrease rate of PEF (P 0.05). 7. FEV1, the decrease rate of PEF was positively correlated with the decrease rate of FEF 75, FEF 50 and MMEF (P 0.05). However, there was no significant correlation between age (age) and the decrease rate of small airway parameters (FEF 75%, FEF 50%, MMEF). There was no statistical significance (P 0.05). PEF, FEF 75%, FEF 50% and MMEF were significantly improved in group B after treatment. There was no significant difference in age between patients with normal small airway function and asthmatic patients with abnormal small airway function. It is very important to monitor the small airway parameters for early diagnosis, timely prevention and evaluation of asthma.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R562.25

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