Chang Chun, Wang Xiao-Hong, Yao Wan-Zhen, Liu Xiao-Fang, Hang Yan-Jing
Department of Respiratory Medicine, Peking University Third Hospital, Beijing 100083, China.
Zhonghua Jie He He Hu Xi Za Zhi. 2008 Mar;31(3):191-5.
To evaluate the effects of different doses of salbutamol and observation times on bronchodilation test.
Three groups of subjects (30 patients with asthma, 29 patients with COPD, and 30 normal controls) were included in this study. The forced expiratory volume in the first second (FEV1) was evaluated in the positive rates at 15, 20, and 30 min after inhaling 200 microg or 400 microg salbutamol. On day 2, another dose of salbutamol was inhaled, and FEV1 measurement was performed repeatedly. SPSS 10.0 was used for statistical analysis. The positive rates after inhaling 200 microg and 400 microg salbutamol at the 15, 20 and 30 min were compared with chi-square test.
Using absolute change of FEVY1 > 200 ml and improving rate of FEV1 > or = 12% as the positive standard, the positive rate of the asthmatic subjects at 15, 20, and 30 min after inhaling 200 microg salbutamol was 28/30 (93.3%), 28/30 (93.3%) and 28/30 (93.3%, chi2 = 0.00, P > 0.05). The positive rate of the asthmatic subjects at 15, 20 and 30 min after inhaling 400 microg salbutamol was 28/30 (93.3%), 29/30 (96.7%), 27/30 (90.0%, chi2 = 1.07, P > 0.05). The positive rate at 15, 20 and 30 min were not significantly different between patients inhaling 200 microg and 400 microg salbutamol (chi2 = 0.00, 0.00, 0.00, all P > 0.05). In the patients with COPD and in normal controls, the positive rate was not significantly different between patients inhaling 200 microg and 400 microg salbutamol. There was also no difference in the positive rate at different time. If using absolute change of FEVY1 > 200 ml and improving rate of FEV1 > or = 12% as the positive standard, the best combination of sensitivity and specificity of diagnosing asthma was achieved. The sensitivity was 93.3% and the specificity was 98.3%.
FEV1 at 15 min after inhaling 200 microg salbutamol is the best choice as it is highly efficient and causes less side effects. We suggest that an absolute increase of FEV1 > 200 ml and improving rate of FEV1 > or = 12% to be the positive standard of diagnosing asthma.
评估不同剂量沙丁胺醇及观察时间对支气管舒张试验的影响。
本研究纳入三组受试者（30例哮喘患者、29例慢性阻塞性肺疾病（COPD）患者和30例正常对照者）。吸入200μg或400μg沙丁胺醇后15、20和30分钟，评估第一秒用力呼气容积（FEV1）的阳性率。第2天，吸入另一剂量的沙丁胺醇，并重复进行FEV1测量。采用SPSS 10.0进行统计分析。吸入200μg和400μg沙丁胺醇后15、20和30分钟的阳性率采用卡方检验进行比较。
以FEV1绝对值增加>200ml且FEV1改善率>或=12%作为阳性标准，吸入200μg沙丁胺醇后15、20和30分钟哮喘受试者的阳性率分别为28/30（93.3%）、28/30（93.3%）和28/30（93.3%，χ2=0.00，P>0.05）。吸入400μg沙丁胺醇后15、20和30分钟哮喘受试者的阳性率分别为28/30（93.3%）、29/30（96.7%）、27/30（90.0%，χ2=1.07，P>0.05）。吸入200μg和400μg沙丁胺醇的患者在15、20和30分钟时的阳性率无显著差异（χ2=0.00、0.00、0.00，均P>0.05）。在COPD患者和正常对照者中，吸入200μg和400μg沙丁胺醇的患者阳性率无显著差异。不同时间的阳性率也无差异。以FEV1绝对值增加>200ml且FEV1改善率>或=12%作为阳性标准，诊断哮喘的敏感性和特异性最佳组合得以实现。敏感性为93.3%，特异性为98.3%。
吸入200μg沙丁胺醇后15分钟的FEV1是最佳选择，因为其效率高且副作用少。我们建议将FEV1绝对值增加>200ml且FEV1改善率>或=12%作为诊断哮喘的阳性标准。
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