南方医科大学学报2017，Vol.37Issue(3)：330-336,7.DOI:10.3969/j.issn.1673-4254.2017.03.09
典型哮喘与咳嗽变异性哮喘的小气道功能差异分析
Comparison of functional parameters of small airways between patients with typical asthma and cough-variant asthma
摘要
Abstract
Objective To compare the functional parameters of the small airways and clinical characteristics between patients with typical asthma (TA) and cough-variant asthma (CVA).Methods Forty-three newly diagnosed asthmatic patients were enrolled,including 15 with TA and positive bronchial provocation test [TA BPT(+)],12 with TA and positive bronchial dilation test [TA BDT(+)] and 16 with CVA,and 27 healthy subjects served as the control group.All the subjects were required to complete data acquisition,asthma control test,asthma control test scale,fractional exhaled nitric oxide,airway resistance and pulmonary function tests,BPT or BDT.Results The interval from onset to a definite diagnosis of TA BDT(+) was longer than that of TA BPT(+),while that of CVA was the shortest (P=0.022).The pulmonary functional parameters of TA BDT (+) was significantly lower than those of the other 3 groups (P＜0.05).MMEF,MEF75,MEF50,and MEF25 in patients with TA BDT(+),TA BPT(+) and CVA were significantly lower than those in the control group (P＜0.01).The resonant frequency,respiratory impedance,resistance at 5 Hz,resistance at 20 Hz,and reactance at 5 Hz were significant higher in patients with TA BDT (+) than in the control subjects,while these parameters showed no significant differences among TA BPT (+),CVA and control groups.The airway resistance in TA BPT(+),CVA,and control groups increased after BPT,and the patients with TA BPT(+) showed greater changes in airway resistance than those in CVA and control groups.In CVA patients,FeNO showed a strong positive correlation with respiratory impedance (r=0.523,P=0.038),resistance at 5 Hz (r=0.542,P=0.030),and resistance at 20 Hz (r=0.524,P=0.037),and the airway responsiveness showed a strong positive correlation with resistance at 20 Hz (p=-0.512,P=0.043).Conclusion CVA is the early stage of TA,and CVA,TA BPT(+),and TA BDT(+) may represent different stages of asthma.Uncontrolled,prolonged CVA may evolve into TA BPT (+),whose further progression can cause damages of the pulmonary function and small airway function and leads eventually to TA BDT (+).关键词
典型哮喘/咳嗽变异性哮喘/小气道功能/脉冲震荡Key words
typical asthma/cough-variant asthma/small airway function/impulse oscillometry引用本文复制引用
陈树煜,方泽葵,方思,沈其晓,何熹,王翠兰,于化鹏..典型哮喘与咳嗽变异性哮喘的小气道功能差异分析[J].南方医科大学学报,2017,37(3):330-336,7.基金项目
广东省科技计划项目(2014A020212395) （2014A020212395）
