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[正常呼吸时出现哮鸣音作为支气管阻塞的体征]

[Wheezing during normal breathing as a sign of bronchial obstruction].

作者信息

Gross V, Reinke C, Dette F, Koehler U

机构信息

Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin (Direktor: Prof. Dr. C. Vogelmeier), Philipps-Universität Marburg.

出版信息

Pneumologie. 2009 Jan;63(1):6-9. doi: 10.1055/s-2008-1038271. Epub 2008 Oct 29.

Abstract

Wheezing is a clinical feature in patients with chronic obstructive airway diseases. Long-term monitoring of wheezing could provide a new dimension of diagnostic information as compared to lung function if wheezing really does represent airway obstruction. Patients with wheezing who were part of our Marburg Respiratory Sound Database (MARS) were studied. 20 patients with asthma and 17 patients with chronic obstructive pulmonary disease (COPD) were analysed with respect to pathological changes of lung function parameters. The patients were matched with persons without wheezing in regard to age, diagnosis and sex. Additionally, 58 healthy persons with normal lung function tests were analysed for the occurrence of spontaneous wheezing during normal breathing. In patients with wheezing, at least one parameter of lung function was pathological. For asthmatic patients significant differences for MEF (50) (p = 0.011), R (tot) (p = 0.002) and Tiffeneau (p = 0.001) were found. In patients with COPD significant differences for FEV (1) (p = 0.002) and MEF (50) (p = 0.030) were found. In none of the healthy persons with normal lung function did we find wheezing. Wheezing as a clinical sign of bronchial obstruction is useable for long-term monitoring. The method provides additional information that can help to monitor nocturnal asthma.

摘要

哮鸣是慢性阻塞性气道疾病患者的一项临床特征。如果哮鸣确实代表气道阻塞,那么与肺功能相比,对哮鸣进行长期监测可为诊断信息提供一个新的维度。对纳入我们马尔堡呼吸音数据库(MARS)的哮鸣患者进行了研究。分析了20例哮喘患者和17例慢性阻塞性肺疾病(COPD)患者肺功能参数的病理变化。这些患者在年龄、诊断和性别方面与无哮鸣者相匹配。此外,对58例肺功能测试正常的健康人在正常呼吸时出现自发性哮鸣的情况进行了分析。在哮鸣患者中,至少有一项肺功能参数呈病理性。对于哮喘患者,发现最大呼气流量(50)(MEF(50))(p = 0.011)、总气道阻力(R(tot))(p = 0.002)和蒂芬诺指数(Tiffeneau)(p = 0.001)存在显著差异。对于COPD患者,发现第1秒用力呼气容积(FEV(1))(p = 0.002)和MEF(50)(p = 0.030)存在显著差异。在肺功能正常的健康人中均未发现哮鸣。哮鸣作为支气管阻塞的临床体征可用于长期监测。该方法可提供有助于监测夜间哮喘的额外信息。

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