Nishimura K, Mio T, Koyama H, Izumi T
Second Department of Internal Medicine, Kyoto University, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1991 Jun;29(6):685-92.
Diffuse panbronchiolitis (DPB) is a disease characterized clinically by chronic airflow limitation, therefore patients with DPB are frequently treated with bronchodilators. However, there have been no reports on bronchodilator effects in patients with DPB. Because bronchodilator effects can be influenced by low baseline level of pulmonary function, we evaluated acute responses to inhaled metaproterenol (10 mg) in 31 patients with DPB and in 40 patients with pulmonary emphysema. Patients of both groups were clinically diagnosed, and, in addition, by usage of high-resolution computed tomography. All the subjects in both groups had a post-bronchodilator FEV1/FVC less than 0.7. There was no difference in baseline FEV1 between either group; FEV1 was 1.24 +/- 0.64 l (47.1 +/- 17.8% pred) in DPB vs. 1.24 +/- 0.64 l (51.0 +/- 19.0% pred) in pulmonary emphysema. Two indices, post FEV1/pre FEV1 and post FEV1-pre FEV1/predicted FEV1, were used for the judgement of bronchodilator response. Post FEV1/pre FEV1 was 110.3 +/- 9.3% in DPB and 119.9 +/- 17.1% in pulmonary emphysema. Post FEV1-pre FEV1/predicted FEV1 was 4.5 +/- 4.2% in DPB and 8.6 +/- 6.2% in pulmonary emphysema. Bronchodilator responses for both indices was larger in pulmonary emphysema than in DPB (both, p less than 0.01). It has been reported that post FEV1/pre FEV1 correlates negatively to baseline FEV1 and that post FEV1-pre FEV1/predicted FEV1 is positively correlated to baseline FEV1.(ABSTRACT TRUNCATED AT 250 WORDS)
弥漫性泛细支气管炎(DPB)是一种临床上以慢性气流受限为特征的疾病,因此DPB患者常使用支气管扩张剂进行治疗。然而,关于DPB患者使用支气管扩张剂的效果尚无报道。由于支气管扩张剂的效果可能受肺功能基线水平较低的影响,我们评估了31例DPB患者和40例肺气肿患者吸入间羟异丙肾上腺素(10mg)后的急性反应。两组患者均经临床诊断,此外还使用了高分辨率计算机断层扫描。两组所有受试者支气管扩张剂使用后的FEV1/FVC均小于0.7。两组的基线FEV1无差异;DPB患者的FEV1为1.24±0.64L(占预计值的47.1±17.8%),肺气肿患者为1.24±0.64L(占预计值的51.0±19.0%)。使用两个指标,即FEV1后/FEV1前和(FEV1后 - FEV1前)/预计FEV1来判断支气管扩张剂反应。DPB患者的FEV1后/FEV1前为110.3±9.3%,肺气肿患者为119.9±17.1%。DPB患者的(FEV1后 - FEV1前)/预计FEV1为4.5±4.2%,肺气肿患者为8.6±6.2%。肺气肿患者两个指标的支气管扩张剂反应均大于DPB患者(均p<0.01)。据报道,FEV1后/FEV1前与基线FEV1呈负相关,(FEV1后 - FEV1前)/预计FEV1与基线FEV1呈正相关。(摘要截取自250字)