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1、支气管舒张试验诊断标准临床探究［摘要］目的: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,COPD患者50例，健康对照组50例，吸入200pg和400pg沙丁胺醇，于15min后,重复测定FEW,计算舒张试验阳性率。结果:以FEV1改善率>15%且FEW增加绝对值>200ml舒张试验阳性标准判断,诊断哮喘的灵敏度为76%,特异性可达到100%似FEV1改善率邛2%且FEV1增加绝对值>200ml舒张试验阳性标准判定其舒
2、张试验阳性结果，灵敏度为92%,特异性可达到99%;以FEV1改善率邛0%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)oCOPD组和健康对照组舒张试验阳性率与吸入沙丁胺醇的剂量亦无相关性(P>0.05)o结论:支气管舒张试验中，采用200pg沙丁胺當的剂量可以充分发挥其舒张支气管的良好效能，增加剂量对其阳性结果无统计学意义;以FEV1改善率邛2%且FEV1增加绝对值>200ml舒张试验阳性判断标准,诊断哮
3、喘的临床价值更大，能够有效减少误诊率和漏诊率。［关键词］哮喘;慢性阻塞性肺疾病;呼吸功能试验;沙丁胺［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,GeneralHospitalofB
4、enxiIronandSteelCompany,Benxi117000,China)［Abstract］Objective:Tocompareandanalyzetheeffectsofdifferentstandandsofdiagnosingonbronchodilationtest.Methods:Threegroupsofsubjects(50patientswithasthma,50patientswithCOPD,and50normalcontrol)wereinducedinthiss
5、tudy.Theforcedexpiratoryvolumeinthefirstsecond(FEV1)wasevaluatedinthepositiveratesat15minutesafterinhaling200pgor400pgsalbutamol.Results:IfusingabsolutechangeofFEV1>200mlandimprovingrateFEV1>15%asthepositivestandard,thebestcombinationofsensitivity(76%)
6、andspecificity(100%)ofdiagnosingasthmawasachieved.IfusingabsolutechangeofFEV1>200mlandimprovingrateofFEV1>12%asthepositivestandard,thebestcombinationofsensitivity(92%)andspecificity(99%)ofdiagnosingasthmawasachieved.IfusingimprovingrateFEV1>10%asthepos
7、itivestandard,thebestcombinationofsensitivity(100%)andspecificity(80%)ofdiagnosingasthmawasachieved・Therewasnosignificantdifferencebetweenpatientsinhaling200pgsalbutamol.InthepatientswithCOPDandinnormalcontrol,thepositiveratewasnosignificantdifferenceb
8、etweenpatientsinhalingdifferentdoseofsalbutamol.Conclusion:FEV1at15minutesafterinhaling200pgsalbutamolisthebestchoiceasitishighlyefficientandcauselesssideeffects・WesuggestthatanabsoluteincreaseofFEV1>200mlandimprovingrateFEV1>12%shouldb
