支气管哮喘合并慢性阻塞性肺病的临床特点和肺功能研究
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摘要
目的比较慢性阻塞性肺病(以下简称COPD)、支气管哮喘以及支气管哮喘合并COPD患者的临床特点以及行支气管舒张试验前后肺功能指标的异同之处,以探讨支气管舒张试验对三组疾病的诊断与鉴别诊断的意义,及其对哮喘合并COPD临床研究的价值。方法选择2005-2007年间350例经结合临床特征及支气管舒张试验的结果确诊分为支气管哮喘、COPD和支气管哮喘合并COPD三组的患者,将其临床特点及支气管舒张试验前后的肺功能指标进行比较分析。结果①临床资料比较:单纯哮喘组患者女性多于男性,在三组中患病年龄最年轻,病程最短,有吸烟史者最少,吸烟指数最小,有哮喘家族史者比例最大,单纯COPD组与哮喘合并COPD组患者一般资料和病史较相似;单纯哮喘组患者肺部体征以单纯哮鸣音为主,血常规以嗜酸性粒细胞增高为主,而单纯COPD组患者肺部体征以干湿啰音并存为主，血常规以中性粒细胞增高为主,哮喘合并COPD组的以上项目则介于单纯COPD与哮喘组之间。②肺功能比较:行支气管舒张试验前FEV1%、FEV1/FVC%、MMEF%值三组之间两两比较均有差异,哮喘合并COPD组气流受限最重,其次为单纯COPD组,单纯哮喘组最轻,同时FVC%、PEF%和sGaw%单纯哮喘组最大,Raw%最小,而单纯COPD组与哮喘合并COPD组以上指标较接近;支气管舒张试验后Raw%值三组两两比较均有差异,单纯哮喘组气道阻力最低,其次为哮喘合并COPD组,单纯COPD组最大,且哮喘合并COPD组的FEV1%、MMEF%和FVC%的改变率最大,PEF%、Raw%和sGaw%的改变率则接近于单纯哮喘组水平,单纯COPD组则以上肺功能指标的改变率最小。结论哮喘合并COPD组患者行支气管舒张试验前其大、小气道气流受限最重,支气管舒张试验后肺活量明显增高,气道阻力下降,且呼气流速改变率最大,其气流受限的可逆性介于单纯哮喘和COPD组之间,故支气管舒张试验有助于哮喘、COPD以及哮喘合并COPD的诊断和鉴别诊断,为哮喘合并COPD的临床研究提供了有力的依据。
Objective To coduct a comparison with the pulmonary ventilation function of chronic obstructive pulmonary diseasese(COPD) and Asthma as well as combination of two diseases before and after inhaling salbutamol, simultaneous contrast to their clinical characteristics,so as to approach the significance of three groups’diagnose and antidiastole by means of broncho dilatation test as well as its value to the clinical research of Asthma combing with COPD. Methods To select 350 cases patients from 2005 to 2007who were final diagnosed and separated to three groups of Asthma、COPD and Asthma combing with COPD through connecting the clinical feature with their results of broncho dilatation test,then to compare with and analyze their clinical feasures and the pulmonary function parameter before and after broncho dilatation test. Results①compare with the clinical data:The patients of simple Asthma group who are female exceeding male,whose ages with disease are the youngest among the three groups, whose courses of disease are the shortest,the smoker are the least,the smoking exponent are the smallest as well as the proportion of those who have the family history are the biggest,while the general datas and case histories of simple COPD and Asthma combing with COPD are similar;the bellows objectives of simple Asthma group are mainly purely wheezing rale,and whose blood rules are mainly the acidophilic granulocyte,while the bellows objectives of simple COPD group are mainly the dry rales concomitance moist rales,and whose blood rules are mainly neutral granular cell ,the items above of Asthma combing with COPD group are between simple Asthma and COPD groups.②compare with the pulmonary function: there are all significance difference among three groups and comparing with each other in the target of FEV1%、FEV1/FVC% and MMEF% before the broncho dilatation test,the air current limited of Asthma combing with COPD group are the most serious,next to simple COPD group and which of simple Asthma group are lightest,at the same time the target of FVC%、PEF%、and sGaw% of simple Asthma group are the biggest,and Raw% are the smallest,while the target above of simple COPD and Asthma combing with COPD groups are fairly closing. There are all difference among three groups and comparing with each other in the target of Raw% after broncho dilatation test,the airway resistance of simple Asthma group are the lowest,next to Asthma combing with COPD group and which of simple COPD group are the largest,furthermore the variabilities of FEV1%、MMEF% and FVC% in Asthma combing with COPD group are the largest, and the variabilities of PEF%、Raw% and sGaw% close to the level of simple Asthma group,while the variabilities of pulmonary function parameter above in simple COPD group are the smallest. Conclusion The large and small airway air current limited of Asthma combining with COPD group are the most serious before broncho dilatation test, its lung capacity have increased and the airway resistance decended obviously, as well its variabilities of expiratory flow rate are the largest,its reversability of the air current limited is between simply Asthma and COPD groups.Therefore,the broncho dilatation test conduce to the diagnosis and antidiastole of Asthma and COPD as well Asthma combing with COPD,meanwhile it can provide the emphatic evidence to the clinical research of Asthma combing with COPD.
Objective To coduct a comparison with the pulmonary ventilation function of chronic obstructive pulmonary diseasese(COPD) and Asthma as well as combination of two diseases before and after inhaling salbutamol, simultaneous contrast to their clinical characteristics,so as to approach the significance of three groups’diagnose and antidiastole by means of broncho dilatation test as well as its value to the clinical research of Asthma combing with COPD. Methods To select 350 cases patients from 2005 to 2007who were final diagnosed and separated to three groups of Asthma、COPD and Asthma combing with COPD through connecting the clinical feature with their results of broncho dilatation test,then to compare with and analyze their clinical feasures and the pulmonary function parameter before and after broncho dilatation test. Results①compare with the clinical data:The patients of simple Asthma group who are female exceeding male,whose ages with disease are the youngest among the three groups, whose courses of disease are the shortest,the smoker are the least,the smoking exponent are the smallest as well as the proportion of those who have the family history are the biggest,while the general datas and case histories of simple COPD and Asthma combing with COPD are similar;the bellows objectives of simple Asthma group are mainly purely wheezing rale,and whose blood rules are mainly the acidophilic granulocyte,while the bellows objectives of simple COPD group are mainly the dry rales concomitance moist rales,and whose blood rules are mainly neutral granular cell ,the items above of Asthma combing with COPD group are between simple Asthma and COPD groups.②compare with the pulmonary function: there are all significance difference among three groups and comparing with each other in the target of FEV1%、FEV1/FVC% and MMEF% before the broncho dilatation test,the air current limited of Asthma combing with COPD group are the most serious,next to simple COPD group and which of simple Asthma group are lightest,at the same time the target of FVC%、PEF%、and sGaw% of simple Asthma group are the biggest,and Raw% are the smallest,while the target above of simple COPD and Asthma combing with COPD groups are fairly closing. There are all difference among three groups and comparing with each other in the target of Raw% after broncho dilatation test,the airway resistance of simple Asthma group are the lowest,next to Asthma combing with COPD group and which of simple COPD group are the largest,furthermore the variabilities of FEV1%、MMEF% and FVC% in Asthma combing with COPD group are the largest, and the variabilities of PEF%、Raw% and sGaw% close to the level of simple Asthma group,while the variabilities of pulmonary function parameter above in simple COPD group are the smallest. Conclusion The large and small airway air current limited of Asthma combining with COPD group are the most serious before broncho dilatation test, its lung capacity have increased and the airway resistance decended obviously, as well its variabilities of expiratory flow rate are the largest,its reversability of the air current limited is between simply Asthma and COPD groups.Therefore,the broncho dilatation test conduce to the diagnosis and antidiastole of Asthma and COPD as well Asthma combing with COPD,meanwhile it can provide the emphatic evidence to the clinical research of Asthma combing with COPD.
引文
[1]中华医学会呼吸病学分会慢性阻塞性肺疾病学组.慢性阻塞性肺疾病诊治指南[J].中华结核和呼吸杂志,2007,25(8):453-460
[2]中华医学会呼吸病学分会慢性阻塞性肺疾病学组.慢性阻塞性肺疾病诊治指南[J].中华结核和呼吸杂志,2007,25(8):453-460
[3]王铁军,罗勇,施萍.COPD患者PEFR与FEV1相关性分析[A].临床内科杂志,1999,16(4):210-211
[4]王铁军,施萍. COPD患者PEFR与其它肺功能参数相关性研究[A].中国实用内科杂志,2001, 21(3):151-152
[5]姚婉贞,韩翔,刘亚等. FEV1%与FEV1/FVC作为COPD气流阻塞判定指标的比较研究[A].中国实用内科杂志,2000,20(3):141-142
[6]李国华,吕小伟,马永信等.FEV1、FEV/FVC对COPD气流阻塞的判断价值[J].山东医药,2003,43(31):38
[7]李清,谢高强,程显声等. 4年间气道高反应性对慢性阻塞性肺疾病发病影响的随访研究[A].中华结核和呼吸杂志,2001,24(10): 58-59
[8]夏利萍,周一平.气道高反应性测定及临床应用[J].实用诊断与治疗杂志,2003,17(3):209-210
[9]王美琴,钮善福,李燕芹等.呼吸阻抗对慢性阻塞性肺疾病的诊断价值[J].中国急救医学,1999,19(8): 460-461
[10]郭忠良,蔡映云,梁永杰等.脉冲振荡法测定慢性阻塞性肺疾病患者呼吸阻抗与常规肺功能的关系[J].现代康复,2001,5(2):56-57.
[11]苏丽玲. 201例老年慢性阻塞性肺疾病患者肺功能观察[J].广州医药, 1999,30(3): 39-40
[12]陈荣昌.肺功能检查在COPD诊治中的应用[M].实用医学杂志,2002,18(7): 681-682
[13]吴京,孙玉桂,栾芳.慢性阻塞性肺疾病患者肺功能参数的改变[J].中国临床康复,2003,7(15):2228-2229
[14]张皓,蔡映云.平静呼吸肺功能测试在慢性阻塞性肺病中的应用[J].现代康复,2001,8(5):38-39
[15]苏光英. 110例慢性阻塞性肺病患者肺功能检测结果分析[J].山东医药,2003, 43(20): 59-60
[16] Doherty, Dennis E. MD, FCCP. Identification and Assessment of Chronic ObstructivePulmonary Disease in the Elderly. The American College of Medical Directors,Volume 4(5) Supplement, September/October 2003: 116-120
[17] Fink,Gershon MD; Moshe et al.Functional Evaluation in Patients With Chronic Obstructive Pulmonary Disease: Pulmonary Function Test Versus Cardiopulmonary Exercise Test. Lippincott Williams & Wilkins, Inc,Volume 44(1),January 2002: 54-58
[18]叶丽川,刘春涛.长效B2受体激动剂在慢性阻塞性肺疾病中的应用[J].中国呼吸与危重监护杂志,2003,2(4): 256-257
[19]周鸿,吕波,黄瑾.支气管舒张试验的临床应用探讨[J].中国实验诊断学, 2006,10(2): 138-141
[20]周新,韩伟. COPD预后评价指标的研究[A].中国实用内科杂志,2006,26(18): 1389- 1390
[21]杨宇路.肺功能参数在哮喘诊断和评估中的应用价值[J].现代康复,2001,5(5):77-78
[22]尹刚,张玲,徐静等.哮喘的肺功能检查[J].青岛医药卫生,1999,31(1):67-68
[23]王玉珍,穆亚东,刘瑞芳.支气管哮喘患者肺功能随访及评价[J].河南医药信息,2000, 8(10): 16-17
[24]罗文熙,梁标,全彩娟等.支气管哮喘患者缓解期肺功能及气道阻塞可逆性的观察[J].中国民康医学, 2006,18(4): 247-248
[25] Chang, Herng-Yu Sucie AB, Togias et al. The Effects of Systemic Lidocaine on Airway Tone and Pulmonary Function in Asthmatic Subjects. International Anesthesia Research Society, Volume 104(5), May 2007:1109-1115
[26] Reddel, Helen K. Peak flow monitoring in clinical practice and clinical asthma trials. Lippincott Williams & Wilkins, Inc, Volume 12(1), January 2006:75–81.
[27] Roy, Sitesh R. MD. Asthma. Southern Medical Association, Volume 96(11), November 2003: 1061-1067
[28]官和立,周晖,杨滢等.成人哮喘的FEV1变化[J]. Journal of Occupational Heath and Damage,2004,Vol ,19(2):110-111
[29]叶正龙,吴火宝,赵来荣.支气管哮喘缓解期小气道功能测定及预防[J].医学理论与实践,2001,14(8):724-725
[30]李敏然,郑劲平,钟南山.气道阻力在支气管哮喘患者疗效判定中的应用[A].中华结核和呼吸杂志,2000,23(2): 105-106
[31]赖映君,吴福成,樊萍等.比气道传导率测定在症状不典型哮喘患者中的应用[J].临床荟萃,2004,19(6): 308-309
[32]李银环,高艳,张生山等.支气管舒张试验小气道指标对哮喘的诊断价值[J].宁夏医学院学报, 2006 ,28(4): 32-33
[33]宋玉,佟振月,刘刚等.哮喘病人舒张试验多项指标的比较及临床意义[A].中国医科大学学报,2003,32(3): 24-26
[34]田军平,李君涛,王桂英.支气管扩张试验在临床哮喘诊断中的应用[J].华北煤炭医学院学报,2006,8(1): 68-69
[35]赖映君,陈升汶.哮喘患者支气管扩张试验肺功能参数变化[J].广东医学, 2002,23(12):1300-1301
[36]李敏然,郑劲平,钟南山.典型支气管哮喘和咳嗽变异型哮喘患者肺功能的比较[A].中华内科杂志,1999,38(7): 482-483
[37]陈桂霞,李凤玲,范瑞杰.咳嗽变异型哮喘和典型支气管哮喘患者肺功能及气道反应性特点的比较分析[J].中国煤炭工业医学杂志,2001,4(7): 511-512
[38]袁庆莉.咳嗽变异型哮喘的临床及肺功能特征[A].郧阳医学院学报,2001, 20(4):211-212
[39]王玉萍,吴殿义.咳嗽变异型哮喘肺功能改变[J]. Chinese Medical Journal of Metallurgical Industry,June2006,Vol 123 No 13: 42-44
[40]张晓云,张焕萍,杨小明.成人咳嗽变异型哮喘20例临床及肺功能特征[J].山西医科大学学报,1999,30(2): 121-122
[41]梁远淙,蔡文华.肺功能检查及其道反应性测定提高咳嗽变异性哮喘诊断率的研究(附296例报告)[J].临床荟萃,1999,14(4):150
[42]俞永宝,吴荣辉,陈考珍.肺功能测定对咳嗽变异型哮喘的诊断意义[J].华夏医学, 2001, 14(3): 28-29
[43]田立芝,魏浩成,王惠芬.肺功能检测在哮喘和COPD中的应用价值[J].天津医药,2006,34(9): 656-657
[44]尚天荣,周志敏.慢性阻塞性肺病稳定期与支气管哮喘缓解期肺通气功能比较[J].实用诊断与治疗杂志,2006,20(6): 456-457
[45]周敏,倪谨华,郑丽叶等.信必可都保对持续性哮喘的疗效观察[A].上海第二医科大学学报,2005,25(1):74-75
[46]黄隽英,吴国成,张文雅.沙美特罗氟替卡松吸入对慢性中度持续哮喘患者肺功能的影响[A].苏州大学学报(医学版),2007,27(2): 287-288
[47]叶永青,张孔.舒利迭对慢性阻塞性肺疾病患者肺功能的影响[J].现代预防医学,2005,32(8): 90-91
[48]刘霞,田路稳,邵伯云.舒利迭治疗成人轻中度支气管哮喘临床观察[J].青海医药杂志,2006,36(11): 141-142
[49]王迪.舒利迭治疗支气管哮喘的临床观察[J].临床和实验医学杂志,2007, 6(2):11-12
[50]王建平,鲁德,杨燕.孟鲁斯特用于稳定期慢性阻塞性肺疾病患者疗效观察[J].山东医药,2007,47(5): 40-41
[51]冯可青.可必特雾化吸入对支气管哮喘患者肺功能的影响[J].中原医刊,2006,33(18): 211-212
[52]陈敏,王晓霞,练祥忠.溴化异丙托品对哮喘和COPD的支气管扩张作用的肺功能观察[A].华西医学,2006,21(3): 503-504
[53]陆鸿雁.雾化吸入溴化异丙托品治疗慢性阻塞性肺疾病52例疗效及肺功能分析[J].陕西医学杂志,2002,31(3): 222-223
[54]程春虹,郑德玲,韦杰.长期吸入糖皮质激素治疗慢性阻塞性肺病的研究[J].职业卫生与病伤,2003,18(4): 25-26.
[55]路明,姚婉贞.吸入糖皮质激素在慢性阻塞性肺疾病稳定期中的应用[A].国外医学呼吸系统分册,2005,25(6): 47-48.
[56]羊光杰,赵英雄.慢性阻塞性肺疾病合并哮喘32例临床分析[J]. Diagn Concepts Pract 2006,5(2):158-159
[57]官和立,袁玉如,何太灵.支气管哮喘合并COPD与COPD患者气道反应性等肺功能的鉴别比较[A].华西医学,1999,14(1):43-44.
[58]胡水秀,吴日凤.哮喘和慢性阻塞性肺疾病患者小气道功能及气道反应性特点探讨[J].临床荟萃,2007,22(2): 96-97
[59]中华医学会呼吸病学分会.慢性阻塞性肺疾病诊治指南[J].中华结核和呼吸杂志,2002,25:510-153
[60]李平,加孜那.支气管哮喘与慢性阻塞性肺病肺功能的异同(综述)[J].新疆医科大学学报(增刊).
[61] Guerra, Stefan.Overlap of asthma and chronic obstructive pulmonary disease. Lippincott Williams & Wilkins, Inc, Volume 4(2), April 2005:171-177.
[62]赵志强,王金平,王长征.慢性阻塞性肺疾病与支气管哮喘患者气道阻塞可逆性的比较[A].第三军医大学学报, 2003 ,25(7): 644-645
[63] Caramori,Gaetano,Pandit, Anita et al. Is there a difference between chronic airway inflammation in chronic severe asthma and chronic obstructive pulmonary disease? Lippincott Williams & Wilkins, Inc,Volume 5(1), February 2005:77–83
[64] Mohsenin, Amir; Blackburn, Michael R et al. Adenosine signaling in asthma and chronic obstructive pulmonary disease. Lippincott Williams & Wilkins, Inc,Volume 12(1), January 2006:54–59
[1]俞绮虹,刘昌起.支气管哮喘与慢性阻塞性肺病的异同.中华结核和呼吸杂志, 2006,29(6):407-409
[2]中华医学会呼吸病学分会.慢性阻塞性肺疾病诊治指南.中华结核和呼吸杂志,2002,25:510-153
[3]蔡映云,朱砚萍.老年肺功能的变化及其在呼吸病鉴别诊断中的作用.实用老年医学,2001,15(4):173-175
[4]官和立,袁玉如,何太灵.支气管哮喘合并COPD与COPD患者气道反应性等肺功能的鉴别比较.华西医学,1999,14(1):43-44
[5]尚天荣,周志敏.慢性阻塞性肺病稳定期与支气管哮喘缓解期肺通气功能比较.实用诊断与治疗杂志,2006,20(6):456-457
[6]苏光英.110例慢性阻塞性肺病患者肺功能检测结果分析.山东医药,2003,43(20):59-60
[7]曹慧玲,谢程.老年COPD患者小气道功能检测的意义.中国老年学杂志,2003,23:384-385
[8]王廷杰,王家駟.慢性阻塞性肺病患者气道的流速/容积依赖性初步探讨.中国呼吸与危重监护杂志,2002,9(3):175
[9]田立芝,魏浩成,王惠芬等.肺功能检测在哮喘和COPD中的应用价值.天津医药,2006,34(9):656-657
[10] [10] Guerra , Stefano.Overlap of Asthma and Chronic Obstructive Pulmonary Disease.Curr Opin Int Med. 2005, 4(2):171-177
[11]姚婉贞,韩翔等.慢性支气管炎、肺气肿患者弥散功能影响因素的分析。现代康复,2001,5(2):104-105
[12]周新,韩伟.COPD预后评价指标的研究.CHI J PRAC INT MED. 2006,26(18):1388-1390
[13]吕波,周鸿等.哮喘病人支气管舒张反应曲线的研究.中国实验诊断学,2006,10(1):58-62
[14]赵志强,王金平,王长征.慢性阻塞性肺疾病与支气管哮喘患者气道阻塞可逆性的比较.第三军医大学学报,2003,25(7):644-645
[15]郑劲平.肺功能测定临床应用.继续医学教育,26(2):67-71
[16]米天明,杨敬平.应用肺功能检测在气道高反应诊断中临床意义.临床肺科杂志,2005,10(1):97-98
[17]梁斌苗,袁玉如,何太灵等.支气管哮喘患者基础肺功能指标对气道高反应性的预测价值.中国呼吸与危重监护杂志,2004,3(6):404-406
[18]王铁军,施萍.COPD患者PEFR与其它肺功能参数相关性研究.中国实用内科杂志,2001,21(3):151-152
[19]路明,姚婉贞.吸入糖皮质激素在慢性阻塞性肺疾病稳定期中的应用.国外医学呼吸系统分册.2005,25(6):473-477
[20]叶永青,张孔.舒利迭对慢性阻塞性肺疾病患者肺功能的影响.现代预防医学. 2005,32(8):902-904
[21]刘霞,田路稳,卲伯云.舒利迭治疗成人轻、中度支气管哮喘临床观察.青海医药杂志.2006,36(11):15-17
[2]中华医学会呼吸病学分会慢性阻塞性肺疾病学组.慢性阻塞性肺疾病诊治指南[J].中华结核和呼吸杂志,2007,25(8):453-460
[3]王铁军,罗勇,施萍.COPD患者PEFR与FEV1相关性分析[A].临床内科杂志,1999,16(4):210-211
[4]王铁军,施萍. COPD患者PEFR与其它肺功能参数相关性研究[A].中国实用内科杂志,2001, 21(3):151-152
[5]姚婉贞,韩翔,刘亚等. FEV1%与FEV1/FVC作为COPD气流阻塞判定指标的比较研究[A].中国实用内科杂志,2000,20(3):141-142
[6]李国华,吕小伟,马永信等.FEV1、FEV/FVC对COPD气流阻塞的判断价值[J].山东医药,2003,43(31):38
[7]李清,谢高强,程显声等. 4年间气道高反应性对慢性阻塞性肺疾病发病影响的随访研究[A].中华结核和呼吸杂志,2001,24(10): 58-59
[8]夏利萍,周一平.气道高反应性测定及临床应用[J].实用诊断与治疗杂志,2003,17(3):209-210
[9]王美琴,钮善福,李燕芹等.呼吸阻抗对慢性阻塞性肺疾病的诊断价值[J].中国急救医学,1999,19(8): 460-461
[10]郭忠良,蔡映云,梁永杰等.脉冲振荡法测定慢性阻塞性肺疾病患者呼吸阻抗与常规肺功能的关系[J].现代康复,2001,5(2):56-57.
[11]苏丽玲. 201例老年慢性阻塞性肺疾病患者肺功能观察[J].广州医药, 1999,30(3): 39-40
[12]陈荣昌.肺功能检查在COPD诊治中的应用[M].实用医学杂志,2002,18(7): 681-682
[13]吴京,孙玉桂,栾芳.慢性阻塞性肺疾病患者肺功能参数的改变[J].中国临床康复,2003,7(15):2228-2229
[14]张皓,蔡映云.平静呼吸肺功能测试在慢性阻塞性肺病中的应用[J].现代康复,2001,8(5):38-39
[15]苏光英. 110例慢性阻塞性肺病患者肺功能检测结果分析[J].山东医药,2003, 43(20): 59-60
[16] Doherty, Dennis E. MD, FCCP. Identification and Assessment of Chronic ObstructivePulmonary Disease in the Elderly. The American College of Medical Directors,Volume 4(5) Supplement, September/October 2003: 116-120
[17] Fink,Gershon MD; Moshe et al.Functional Evaluation in Patients With Chronic Obstructive Pulmonary Disease: Pulmonary Function Test Versus Cardiopulmonary Exercise Test. Lippincott Williams & Wilkins, Inc,Volume 44(1),January 2002: 54-58
[18]叶丽川,刘春涛.长效B2受体激动剂在慢性阻塞性肺疾病中的应用[J].中国呼吸与危重监护杂志,2003,2(4): 256-257
[19]周鸿,吕波,黄瑾.支气管舒张试验的临床应用探讨[J].中国实验诊断学, 2006,10(2): 138-141
[20]周新,韩伟. COPD预后评价指标的研究[A].中国实用内科杂志,2006,26(18): 1389- 1390
[21]杨宇路.肺功能参数在哮喘诊断和评估中的应用价值[J].现代康复,2001,5(5):77-78
[22]尹刚,张玲,徐静等.哮喘的肺功能检查[J].青岛医药卫生,1999,31(1):67-68
[23]王玉珍,穆亚东,刘瑞芳.支气管哮喘患者肺功能随访及评价[J].河南医药信息,2000, 8(10): 16-17
[24]罗文熙,梁标,全彩娟等.支气管哮喘患者缓解期肺功能及气道阻塞可逆性的观察[J].中国民康医学, 2006,18(4): 247-248
[25] Chang, Herng-Yu Sucie AB, Togias et al. The Effects of Systemic Lidocaine on Airway Tone and Pulmonary Function in Asthmatic Subjects. International Anesthesia Research Society, Volume 104(5), May 2007:1109-1115
[26] Reddel, Helen K. Peak flow monitoring in clinical practice and clinical asthma trials. Lippincott Williams & Wilkins, Inc, Volume 12(1), January 2006:75–81.
[27] Roy, Sitesh R. MD. Asthma. Southern Medical Association, Volume 96(11), November 2003: 1061-1067
[28]官和立,周晖,杨滢等.成人哮喘的FEV1变化[J]. Journal of Occupational Heath and Damage,2004,Vol ,19(2):110-111
[29]叶正龙,吴火宝,赵来荣.支气管哮喘缓解期小气道功能测定及预防[J].医学理论与实践,2001,14(8):724-725
[30]李敏然,郑劲平,钟南山.气道阻力在支气管哮喘患者疗效判定中的应用[A].中华结核和呼吸杂志,2000,23(2): 105-106
[31]赖映君,吴福成,樊萍等.比气道传导率测定在症状不典型哮喘患者中的应用[J].临床荟萃,2004,19(6): 308-309
[32]李银环,高艳,张生山等.支气管舒张试验小气道指标对哮喘的诊断价值[J].宁夏医学院学报, 2006 ,28(4): 32-33
[33]宋玉,佟振月,刘刚等.哮喘病人舒张试验多项指标的比较及临床意义[A].中国医科大学学报,2003,32(3): 24-26
[34]田军平,李君涛,王桂英.支气管扩张试验在临床哮喘诊断中的应用[J].华北煤炭医学院学报,2006,8(1): 68-69
[35]赖映君,陈升汶.哮喘患者支气管扩张试验肺功能参数变化[J].广东医学, 2002,23(12):1300-1301
[36]李敏然,郑劲平,钟南山.典型支气管哮喘和咳嗽变异型哮喘患者肺功能的比较[A].中华内科杂志,1999,38(7): 482-483
[37]陈桂霞,李凤玲,范瑞杰.咳嗽变异型哮喘和典型支气管哮喘患者肺功能及气道反应性特点的比较分析[J].中国煤炭工业医学杂志,2001,4(7): 511-512
[38]袁庆莉.咳嗽变异型哮喘的临床及肺功能特征[A].郧阳医学院学报,2001, 20(4):211-212
[39]王玉萍,吴殿义.咳嗽变异型哮喘肺功能改变[J]. Chinese Medical Journal of Metallurgical Industry,June2006,Vol 123 No 13: 42-44
[40]张晓云,张焕萍,杨小明.成人咳嗽变异型哮喘20例临床及肺功能特征[J].山西医科大学学报,1999,30(2): 121-122
[41]梁远淙,蔡文华.肺功能检查及其道反应性测定提高咳嗽变异性哮喘诊断率的研究(附296例报告)[J].临床荟萃,1999,14(4):150
[42]俞永宝,吴荣辉,陈考珍.肺功能测定对咳嗽变异型哮喘的诊断意义[J].华夏医学, 2001, 14(3): 28-29
[43]田立芝,魏浩成,王惠芬.肺功能检测在哮喘和COPD中的应用价值[J].天津医药,2006,34(9): 656-657
[44]尚天荣,周志敏.慢性阻塞性肺病稳定期与支气管哮喘缓解期肺通气功能比较[J].实用诊断与治疗杂志,2006,20(6): 456-457
[45]周敏,倪谨华,郑丽叶等.信必可都保对持续性哮喘的疗效观察[A].上海第二医科大学学报,2005,25(1):74-75
[46]黄隽英,吴国成,张文雅.沙美特罗氟替卡松吸入对慢性中度持续哮喘患者肺功能的影响[A].苏州大学学报(医学版),2007,27(2): 287-288
[47]叶永青,张孔.舒利迭对慢性阻塞性肺疾病患者肺功能的影响[J].现代预防医学,2005,32(8): 90-91
[48]刘霞,田路稳,邵伯云.舒利迭治疗成人轻中度支气管哮喘临床观察[J].青海医药杂志,2006,36(11): 141-142
[49]王迪.舒利迭治疗支气管哮喘的临床观察[J].临床和实验医学杂志,2007, 6(2):11-12
[50]王建平,鲁德,杨燕.孟鲁斯特用于稳定期慢性阻塞性肺疾病患者疗效观察[J].山东医药,2007,47(5): 40-41
[51]冯可青.可必特雾化吸入对支气管哮喘患者肺功能的影响[J].中原医刊,2006,33(18): 211-212
[52]陈敏,王晓霞,练祥忠.溴化异丙托品对哮喘和COPD的支气管扩张作用的肺功能观察[A].华西医学,2006,21(3): 503-504
[53]陆鸿雁.雾化吸入溴化异丙托品治疗慢性阻塞性肺疾病52例疗效及肺功能分析[J].陕西医学杂志,2002,31(3): 222-223
[54]程春虹,郑德玲,韦杰.长期吸入糖皮质激素治疗慢性阻塞性肺病的研究[J].职业卫生与病伤,2003,18(4): 25-26.
[55]路明,姚婉贞.吸入糖皮质激素在慢性阻塞性肺疾病稳定期中的应用[A].国外医学呼吸系统分册,2005,25(6): 47-48.
[56]羊光杰,赵英雄.慢性阻塞性肺疾病合并哮喘32例临床分析[J]. Diagn Concepts Pract 2006,5(2):158-159
[57]官和立,袁玉如,何太灵.支气管哮喘合并COPD与COPD患者气道反应性等肺功能的鉴别比较[A].华西医学,1999,14(1):43-44.
[58]胡水秀,吴日凤.哮喘和慢性阻塞性肺疾病患者小气道功能及气道反应性特点探讨[J].临床荟萃,2007,22(2): 96-97
[59]中华医学会呼吸病学分会.慢性阻塞性肺疾病诊治指南[J].中华结核和呼吸杂志,2002,25:510-153
[60]李平,加孜那.支气管哮喘与慢性阻塞性肺病肺功能的异同(综述)[J].新疆医科大学学报(增刊).
[61] Guerra, Stefan.Overlap of asthma and chronic obstructive pulmonary disease. Lippincott Williams & Wilkins, Inc, Volume 4(2), April 2005:171-177.
[62]赵志强,王金平,王长征.慢性阻塞性肺疾病与支气管哮喘患者气道阻塞可逆性的比较[A].第三军医大学学报, 2003 ,25(7): 644-645
[63] Caramori,Gaetano,Pandit, Anita et al. Is there a difference between chronic airway inflammation in chronic severe asthma and chronic obstructive pulmonary disease? Lippincott Williams & Wilkins, Inc,Volume 5(1), February 2005:77–83
[64] Mohsenin, Amir; Blackburn, Michael R et al. Adenosine signaling in asthma and chronic obstructive pulmonary disease. Lippincott Williams & Wilkins, Inc,Volume 12(1), January 2006:54–59
[1]俞绮虹,刘昌起.支气管哮喘与慢性阻塞性肺病的异同.中华结核和呼吸杂志, 2006,29(6):407-409
[2]中华医学会呼吸病学分会.慢性阻塞性肺疾病诊治指南.中华结核和呼吸杂志,2002,25:510-153
[3]蔡映云,朱砚萍.老年肺功能的变化及其在呼吸病鉴别诊断中的作用.实用老年医学,2001,15(4):173-175
[4]官和立,袁玉如,何太灵.支气管哮喘合并COPD与COPD患者气道反应性等肺功能的鉴别比较.华西医学,1999,14(1):43-44
[5]尚天荣,周志敏.慢性阻塞性肺病稳定期与支气管哮喘缓解期肺通气功能比较.实用诊断与治疗杂志,2006,20(6):456-457
[6]苏光英.110例慢性阻塞性肺病患者肺功能检测结果分析.山东医药,2003,43(20):59-60
[7]曹慧玲,谢程.老年COPD患者小气道功能检测的意义.中国老年学杂志,2003,23:384-385
[8]王廷杰,王家駟.慢性阻塞性肺病患者气道的流速/容积依赖性初步探讨.中国呼吸与危重监护杂志,2002,9(3):175
[9]田立芝,魏浩成,王惠芬等.肺功能检测在哮喘和COPD中的应用价值.天津医药,2006,34(9):656-657
[10] [10] Guerra , Stefano.Overlap of Asthma and Chronic Obstructive Pulmonary Disease.Curr Opin Int Med. 2005, 4(2):171-177
[11]姚婉贞,韩翔等.慢性支气管炎、肺气肿患者弥散功能影响因素的分析。现代康复,2001,5(2):104-105
[12]周新,韩伟.COPD预后评价指标的研究.CHI J PRAC INT MED. 2006,26(18):1388-1390
[13]吕波,周鸿等.哮喘病人支气管舒张反应曲线的研究.中国实验诊断学,2006,10(1):58-62
[14]赵志强,王金平,王长征.慢性阻塞性肺疾病与支气管哮喘患者气道阻塞可逆性的比较.第三军医大学学报,2003,25(7):644-645
[15]郑劲平.肺功能测定临床应用.继续医学教育,26(2):67-71
[16]米天明,杨敬平.应用肺功能检测在气道高反应诊断中临床意义.临床肺科杂志,2005,10(1):97-98
[17]梁斌苗,袁玉如,何太灵等.支气管哮喘患者基础肺功能指标对气道高反应性的预测价值.中国呼吸与危重监护杂志,2004,3(6):404-406
[18]王铁军,施萍.COPD患者PEFR与其它肺功能参数相关性研究.中国实用内科杂志,2001,21(3):151-152
[19]路明,姚婉贞.吸入糖皮质激素在慢性阻塞性肺疾病稳定期中的应用.国外医学呼吸系统分册.2005,25(6):473-477
[20]叶永青,张孔.舒利迭对慢性阻塞性肺疾病患者肺功能的影响.现代预防医学. 2005,32(8):902-904
[21]刘霞,田路稳,卲伯云.舒利迭治疗成人轻、中度支气管哮喘临床观察.青海医药杂志.2006,36(11):15-17