支气管激发试验对咳嗽变异性哮喘诊断和治疗的新思考

目的：通过分析我院经行支气管激发试验明确诊断的咳嗽变异性哮喘（CVA）的临床和肺功能特点,为诊断和治疗CVA提供一些有益的参考。方法：临床资料采用回顾性分析,共收集142例支气管激发试验阳性而经临床诊断明确为咳嗽变异型哮喘的病例,将其按年龄分为5组,分别对不同年龄组在分布例数、症状特点、肺通气功能、激发剂量进行对比分析。结果：在142例CVA患者中,〈30岁组病例42例（29.6%）,30~40岁组30例（21.1%）,40~50岁组28例（19.7%）,50~60岁组26例（18.3%）,〉60岁组16例（11.3%）。在症状方面,除均有慢性咳嗽（〉3周）外,随着年龄的增大,各组中出现胸闷、气促等症状的病例比例逐渐增多。在肺通气功能方面,〈30岁组的肺通气功能测定明显好于〉60岁组。而另外3组之间组与组之间无明显差异,但各组与〈30岁组及〉60岁组之间均有明显差异。结论：咳嗽变异型哮喘患者以中青年患者居多,老年患者较少,随着年龄的增长,其临床表现及肺通气功能越来越接近典型支气管哮喘,由此推想,若有条件的医院能广泛开展支气管激发试验,对咳嗽变异型哮喘患者进行早期诊断。

The New Thinking About Bronchial Provocation Test in the Diagnosis of Cough Variant Asthma

Objective： The aim of this study is to analyze the clinic and lung function characteristics of cough variant asthma（CVA） diagnosed by bronchial provocation test in our hospital,so as to provide some useful references to the diagnosis and treatment of CVA.Methods： The clinical data adopted a retrospective analysis.142 patients clinically diagnosed as CVA with positive bronchial provocation test,were divide into five groups according to their ages and then aspects were comparatively analyze including the distribution of the number of cases,symptoms characteristic,pulmonary function and provocative dose.Results：Among 142 CVA patients,there are 42 cases younger than 30（29.6%）,30 cases of 30 to 40 years old（21.1%）,28 cases of 40 to 50 years old（19.7%）,26 cases of 50 to 60 year old（18.3%）,16 cases of over 60 years old（11.3%）.As for symptoms,besides chronic cough（over 3 weeks）,it was common that with the age increasing,the proportion of cases with chest tightness,shortness of breath and other symptoms gradually increased in each group.In pulmonary ventilation function,the group of less than 30-year-old was obviously better than the group of over 60 years old.There was no significant difference between the other 3 groups,but the difference was significant between the group of less than 30 years old or over 60 years old and each of the other 3 groups.Conclusion：Cough variant asthma most often occur in young people and fewer in elderly people.With the age increasing,clinical manifestations and pulmonary ventilation function were closer to the typical asthma in elderly patients.Therefore,we conclude that we should carry out bronchial provocation test widely in hospitals with better conditions,for it is helpful in early diagnosis and therapy on CVA patients.