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1、支气管舒张试验诊断标准的临床研究［摘耍］冃的:观察支气管舒张试验中吸入沙丁胺醇不同剂量测定FEV1及不同的阳性标准对支气管舒张试验结果的影响。方法:选择支气管哮喘患者50例,C0PD患者50例，健康对照组50例，吸入200pg和400yg沙丁胺醇，于15min后，重复测定FEV1,计算舒张试验阳性率。结果：以FEV1改善率315%「LFEV1增加绝对值>200ml舒张试验阳性标准判断，诊断哮喘的灵畋度为76%,特界性可达到100%;以FEV1改善率$12%且FEV1增加绝対值>200ml舒张试验阳性标准判定其舒张试验阳性结果，灵敏
2、度为92%,特界性•町达到99%;以FEV1改善率210%为舒张试验阳性标准判断,诊断哮喘的灵敏度为100%,特异性可达到80%。吸入不同剂量沙丁胺醇后舒张试验阳性率比较无显著性差异(P〉0.05)oC0PD组和健康对照组舒张试验阳性率少吸入沙丁胺醇的剂量亦无相关性(P>0.05)。结论:支气管舒张试验中，釆用200yg沙丁胺醇的剂量可以充分发挥其舒张支气管的良好效能,增加剂量对英阳性结果无统计学意义；以FEV1改善率$12%且FEV1增加绝对值>200ml舒张试验阳性判断标准,诊断哮喘的临床价值更大，能够有效减少误诊率和漏诊率。
3、［关键词］哮喘；慢性阻塞性肺疾病；呼吸功能试验；沙丁胺醇［中图分类号］R562.25［文献标识码］A［文章编号］1673-7210(2010)03(a)-029-03ThestandardofdiagnosingonbronchodilationtestWANGBo(DepartmentofRespiratoryMedicine，theFifthAffiliatedHospitalofChineseUniversity,GeneralHospitalofBenxiIronandSteelCompany,Benxi117000,Ch
4、ina)［Abstract］Objective:Tocompareandanalyzetheeffectsofdifferentstandandsofdiagnosingonbronchodilationtest.Methods:Threegroupsofsubjects(50patientswithasthma,50patientswithCOPD,and50normalcontrol)wereinducedinthisstudy.Theforcedexpiratoryvolumeinthefirstsecond(FEV1)wa
5、sevaluatedinthepositiveratesat15minutesafterinhaling200ugor400ugsalbutamol.Results:TfusingabsolutechangeofFEVl>200mlandimprovingrateFEV1^15%asthepositivestandard,thebestcombinationofsensitivity(76%)andspecificity(100%)ofdiagnosingasthmawasachieved・Ifusingabsolutechang
6、eofFEVl>200mlandimprovingrateofFEV1M12%asthepositivestandard,thebestcombinationofsensitivity(92%)andspecificity(99%)ofdiagnosingasthmawasachieved.TfusingimprovingrateFEV1>10%asthepositivestandard,thebestcombinationofsensitivity(100%)andspecificity(80%)ofdiagnosingasth
7、mawasachieved・Therewasnosignificantdifferencebetweenpatientsinhaling200ugsalbutamol.InthepationtswithCOPDandinnormalcontrol,thepositiveratewasnosignificantdifferencebetweenpatientsinhalingdifferentdoseofsalbutamol.Conclusion:FEV1at15minutesafterinhaling200Pgsalbutamol
8、isthebestchoiceasitishighlyefficientandcauselesssideeffects.WesuggestthatanabsoluteincreaseofFEVl>200mlandimprovingrateFEU1M
