中国医学科学院学报

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中国医学科学院学报

中国医学科学院学报 ›› 2009, Vol. 31 ›› Issue (4): 488-493.doi: 10.3881/j.issn.1000-503X.2009.04.021

• 论著 • 上一篇    下一篇

动态肺量测定在支气管哮喘诊断和鉴别诊断中的价值

江宏;韩江娜;许文兵;朱元珏   

  1. 中国医学科学院北京协和医学院北京协和医院呼吸科,北京 100730
  • 收稿日期:2009-05-05 修回日期:1900-01-01 出版日期:2009-08-30 发布日期:2009-08-30
  • 通讯作者: 韩江娜

Diagnostic Specificity of Dynamic Assessment and Monitoring of Spirometry in Asthma

JIANG Hong; HAN Jiang-na; XU Wen-bing; ZHU Yuan-jue   

  1. Department of Pneumology, PUMC Hospital, CAMS and PUMC, Beijing 100730, China
  • Received:2009-05-05 Revised:1900-01-01 Online:2009-08-30 Published:2009-08-30
  • Contact: HAN Jiang-na

摘要: 摘要:目的 评价动态肺量测定在支气管哮喘诊断和鉴别诊断中的价值。方法 回顾性分析在北京协和医院呼吸科完成动态肺量测定检查的145例支气管哮喘患者。每天清晨、下午、入睡前3个时间段对症状和情绪进行自我评估,同时用动态肺量测定仪测定肺功能,连续监测14d。除以上3个规定时间外,患者可根据病情,在任何时间、地点对症状的发作进行肺功能测定。结果 进入分析的145例患者中,男性51例、女性94例,平均年龄(39.1±13.0)岁(10~65岁);平均病程(6.7±9.9)年。得到动态肺量测定证实的支气管哮喘患者126例,占87%。误诊14例(9.7%),过度诊断5例(3.4%)。结论 动态肺量监测通过多时点测定,能够捕捉气道阻塞的可逆性、变异性,弥补了单次时点肺功能检查的缺陷,在支气管哮喘的鉴别诊断中具有不可或缺的价值。

关键词: 支气管哮喘, 肺量测定, 诊断, 鉴别诊断

Abstract: ABSTRACT:Objective To evaluate the diagnostic specificity of dynamic assessment and monitoring using a portable spirometer in diagnosis and differential diagnosis of asthma. Methods We retrospectively reviewed the results of dynamic monitoring of spirometry in 145 symptomatic patients with physician-diagnosed asthma. Flow-volume curve and simultaneous symptoms and mood were measured in a fixed-time thrice-daily assessment schedule for 2 weeks. Patients were allowed to make additional measurements in case of symptom exacerbations. Results The clinical data of 51 males and 94 females with a mean age of(39.1±13.0) years (ranged from 10 to 65 years) were analyzed. Duration of asthma before study was (6.7±9.9) years. Of 145 patients with physician-diagnosed asthma, 126 (87%) could be conclusively confirmed for a diagnosis of asthma. Asthma was misdiagnosed in 14 patients (9.7%). Overdiagnosis of asthma was observed in 5 patients (3.4%). Conclusion Dynamic assessment and monitoring using a portable spirometer by revealing variability and reversibility of airway obstruction may provide an additional tool for diagnosis and differential diagnosis of asthma.

Key words: astdma, spirometry, diacnosis, differential diacnosis