|
|
- 2018
定量雾化器改良高渗盐水支气管激发试验的临床应用价值
|
Abstract:
摘要 目的: 探讨定量雾化器改良高渗盐水支气管激发试验(改良激发试验)的临床应用价值. 方法: 对行乙酰甲胆碱(MCH)支气管激发试验的660例患者及行定量雾化器改良高渗盐水(MHS)支气管激发试验的1 094例患者的临床资料做倾向评分匹配后的回顾性分析,分别观察并对比两种激发试验的阳性率及不良反应. 结果: 改良激发试验与MCH激发试验阳性率分别为9.4%和12.4%,两者阳性率无统计学差异,OR=1.37,95%CI(0.93~2.00);应用改良激发试验时,已诊哮喘患者阳性率高于慢性咳嗽患者,为22.8% 与9.3%,OR=3.18,95%CI(1.59~6.33). MCH激发试验中,已诊哮喘患者的阳性率高于拟诊哮喘患者,OR=0.31,95%CI(0.13~0.73).两种激发试验的比较,改良激发试验在拟诊哮喘组的阳性率高于MCH激发试验OR=2.84,95%CI(1.23~6.52).两者不良反应发生率对比有统计学差异(P<0.05),改良激发试验的呼吸困难发生率高于乙酰甲胆碱(P=0.001). 结论: 改良激发试验与指南推荐的MCH激发试验阳性率、不良反应发生率相近,可用于支气管哮喘的诊断.目前在中国乙酰胆碱和组胺等激发剂被暂停的情况下,改良激发试验可在临床推广应用.
| [1] | 赵培革. 高渗盐水支气管激发试验预测运动性哮喘的价值[J].中国实用内科杂志,2013,33(S1):30-31. |
| [2] | GLOBAL INITIATIVE FOR ASTHMA. Global strategy for asthma management and prevention[EB/OL]. Revised, 2014. http://www.ginasthma.org/. |
| [3] | ZHAO P G.Evaluation of hypertonic saline bronchial provocation test in predicting exercise-induced asthma[J]. Chinese Journal of practical internal medicine, 2013,33(S1):30-31. |
| [4] | 中华医学会呼吸病学分会肺功能专业组.肺功能检查指南(第3部分)-组织胺和乙酰甲胆碱激发试验[J].中华结核和呼吸杂志,2014,34(1):566-571. |
| [5] | LUNG FUNCTION GROUP OF THE CHINESE MEDICAL ASSOCIATION FOR RESPIRATORY DISEASES. Guidelines for the examination of lung function (third part)-histamine and methacholine provocation test[J]. Chinese Journal of Tuberculosis and Respiratory Diseases, 2014, 34(1):566-571. |
| [6] | 中华医学会呼吸病学分会肺功能专业组.肺功能检查指南(第2部分)-肺量计检查[J].中华结核和呼吸杂志,2014,37(8):481-486. |
| [7] | LUNG FUNCTION GROUP OF THE CHINESE MEDICAL ASSOCIATION FOR RESPIRATORY DISEASES. Guidelines for the examination of lung function (second part)-pulmometer examination[J]. Chinese Journal of Tuberculosis and Respiratory Diseases, 2014, 37(8): 481-486. |
| [8] | 成人慢性气道疾病雾化吸入治疗专家组.成人慢性气道疾病雾化吸入治疗专家共识[J].中国呼吸与危重监护杂志,2012,11(2):105-110. |
| [9] | EXPERT GROUP ON NEBULIZATION AND INHALATION FOR CHRONIC AIRWAY DISEASES IN ADULTS. Expert consensus on the treatment of adult chronic airway diseases by nebulization and inhalation therapy[J]. Chinese Journal of Respiratory and Critical Care Medicine, 2012, 11(2): 105-110. |
| [10] | GOKCE N,VITA JA,MC DONNELL M,et al.Effect of medical and surgical weight loss on endothelial vasomotor function in obese patients[J].Am J Cardiol,2011,95(2):266-268. |
| [11] | 刘艳宇,尚云晓,张晗,等.高渗盐水激发试验和运动激发试验用于诊断儿童哮喘的对比观察[J].中国实用儿科杂志, 2009,24(4):305-306. |
| [12] | LIU Y Y, SHANG Y X, ZHANG H, et al.A comparative study of hypertonic saline stimulation test and exercise provocation test in the diagnosis of childhood asthma[J]. Chinese Journal of Practical Pediatrics, 2009,24(4): 305-306. |
| [13] | 黄志俭,祖里培亚,王伟,等.高渗盐水与组胺支气管激发试验在咳嗽变异性哮喘相关性的研究[J].临床肺科杂志,2010,15(6):801-802. |
| [14] | HUANG Z J, ZULI P Y, WANG W, et al.Correlation between hypertonic saline and histamine bronchial provocation test in cough variant asthma[J].Journal of Clinical Pulmonary Medicine, 2010, 15(6): 801-802. |
| [15] | 肖伟民,乔巨峰,温伟宜,等.运动-组胺激发试验对支气管哮喘的诊断价值[J].暨南大学学报(自然科学与医学版),2001,22(2):36-39. |
| [16] | XIAO W M, QIAO J F, WEN W Y, et al.Diagnostic value of exercise histamine challenge test for bronchial asthma[J]. Journal of Jinan University (Natural Science & Medicine Edition),2001,22(2):36-39. |
| [17] | 徐磊,李国华,付秀华,等.10%高渗盐水激发试验对哮喘的诊断价值[J].临床肺科杂志, 2014, 19(6):1013-1015. |
| [18] | XU L, LI G H, FU X H, et al.Diagnosis value of 10% hypertonic saline challenge on asthma[J].Journal of Clinical Pulmonary Medicine, 2014, 19(6): 1013-1015. |
| [19] | CHOI I S, HONG S N, LEE Y K.Ashmatic airway inflammation is more closely related to airway hyperresponsiveness to hypertonie saline than to methacholilie[J]. Korean J Intem Med, 2003, 18(2): 83-85. |
| [20] | 王凡,付红敏,张曼萍,等.以10%高渗氯化钠溶液为激发剂对慢性咳嗽患儿进行支气管激发试验的敏感性和安全性研究[J].中国全科医学,2018,21(2):216-218. |
| [21] | WANG F, FU H M, ZHANG M P, et al.The sensitivity and safety of bronchial provocation test in children with chronic cough with 10% hypertonic sodium chloride solution as provocative agent[J].Chinese General Medicine,2018, 21(2):216-218. |
| [22] | 王羽,单文卫.哮喘儿童高渗盐水激发试验及其临床意义[J].中国医药指南,2010,8(15):57-58. |
| [23] | WANG Y, SHAN W W.Hypertonic saline stimulation test in children with asthma and its clinical significance[J]. Chinese Medicine Guide, 2010,8(15): 57-58. |
| [24] | 许家芬,刘娜,王欢,等.高渗盐水激发试验在儿童慢性咳嗽检查中的应用研究[J].中国医刊,2017,52(2):65-67. |
| [25] | LI D L, HE H, ZHAO Z X.Significance of hypertonic saline bronchial provocation test for management of asthmatic patients[J]. Journal of Guangzhou Medical College, 2013, 41(6):22-25. |
| [26] | 中华医学会呼吸病学分会哮喘学组.支气管哮喘防治指南(支气管哮喘的定义、诊断、治疗和管理方案)[J].中华结核和呼吸杂志,2008,31(3):177-185. |
| [27] | THE ASTHMA GROUP OF THE CHINESE MEDICAL ASSOCIATION OF RESPIRATORY DISEASES. Guidelines for the prevention and treatment of bronchial asthma (the definition, diagnosis, treatment and management of bronchial asthma)[J]. Chinese Journal of Tuberculosis and Respiratory Diseases, 2008, 31(3): 177-185. |
| [28] | XU J F, LIU N, WANG H, et al.Application of hypertonic saline challenge test in children with chronic cough examination[J].China Journal of Medicine, 2017, 52(2): 65-67. |
| [29] | 李点玲,何桦,赵祝香.高渗盐水支气管激发试验对哮喘管理价值的研究[J].广州医学院学报,2013,41(6):22-25. |
