摘要
目的观察吸入生理盐水后的FEV1较基础FEV1的下降率(ΔFEV1),探讨该值与支气管激发试验(BPT)结果的关系。方法选择2008年3月至2009年9月期间在北京大学首钢医院行BPT的慢性咳嗽或胸闷患者115例。先测定FEV1基础值,吸入0.9%生理盐水后再次测定FEV1,计算ΔFEV1。然后用乙酰甲胆碱作支气管激发剂,按BPT结果(阳性或阴性)将患者分为阳性组和阴性组。并结合肺部听诊、生命体征和症状等综合方法监测患者的不良反应,观察试验的安全性。结果 BPT阳性和阴性患者分别为49例和66例。阳性组中有35例吸入生理盐水后FEV1下降>3%,其中20例FEV1下降>5%。阴性组中仅6例FEV1下降>3%,其中无一例下降>5%。以FEV1下降>3%为界,对预测BPT试验阳性结果的敏感度为71%,特异度为91%;以FEV1下降>5%为界,敏感度为40.8%,特异度为100%。所有患者均未发生严重不良反应。结论吸入0.9%生理盐水后ΔFEV>3%可以较好的预判BPT的结果,对这部分患者引起重视可以提高该BPT的安全性。
Objective To observe the decline ratio of FEV1 after inhaling 0.9% saline to the baseline,and to explore its relation to the result of bronchial provocation test （BPT） with methacholine.Methods 115 patients with chronic cough or chest tightness were collected in Shougang Hospital,Peking University from March 2008 to September 2009.They were all performed pulmonary function test and the decline ratio of FEV1 after inhaling 0.9% saline to the baseline（FEV1） was measured.Then they were all performed BPT with methacholine.The predictive value of FEV1 measurement for BPT results was evaluated.Results 49 cases yielded positive results in methacholine BPT,with FEV13% in 35 cases and 5% in 20 cases.66 casess yielded negative results in methacholine BPT,with FEV13% in 6 cases.The sensitivity and specificity were 71% and 91% respectively when FEV13% was set as a cut-off,and which were 40.8% and 100% respectively when FEV15% was set as a cut-off.All the patients didn’t show any serious adverse reaction.Conclusion FEV13% after inhaling 0.9% saline is a good predictor for BPT results.More caution should be paid to these patients when performing BPT.
出处
《中国呼吸与危重监护杂志》
CAS
2010年第3期256-258,共3页
Chinese Journal of Respiratory and Critical Care Medicine
关键词
支气管激发试验
盐水激发
第1秒用力呼气容积
Bronchial provocation test
Provocation test with normal saline
Forced expiratory volume in one second
