Vremaroiu Petrut, Gex Grégoire, Bridevaux Pierre-Olivier
Service de pneumologie, Hôpital de Sion, Hôpital du Valais, 1950 Sion.
Service de pneumologie, HUG, 1211 Genève 14.
Rev Med Suisse. 2016 Sep 7;12(529):1483-1487.
Spirometry with response to short-acting bronchodilators is a key element in the diagnostic work-up of patients with obstructive airways diseases and should be systematically assessed. Response to bronchodilators (RBD) is useful to differentiate asthma from COPD and to grade the severity of obstruction in COPD cases. RBD should not be used to decide for a bronchodilator therapy. An increase in Forced Expiratory Volume in 1 sec (FEV1) or Forced Vital Capacity (FVC) by > 200 ml and 12 % of baseline value is considered as criteria for significant bronchodilator response. With the exception of asthma diagnostic work-up, inhaled therapy should not be interrupted before spirometry. Paradoxical loss of lung function after administration of beta 2 agonists is rarely observed. When present, choice of an alternative bronchodilator agent should be considered.
伴有短效支气管扩张剂反应的肺功能测定是阻塞性气道疾病患者诊断检查的关键要素，应进行系统评估。支气管扩张剂反应（RBD）有助于区分哮喘与慢性阻塞性肺疾病（COPD），并对COPD病例的阻塞严重程度进行分级。RBD不应被用于决定是否进行支气管扩张剂治疗。一秒用力呼气容积（FEV1）或用力肺活量（FVC）较基线值增加>200 ml且增加12%被视为支气管扩张剂显著反应的标准。除哮喘诊断检查外，在进行肺功能测定前不应中断吸入治疗。使用β2激动剂后肺功能出现反常下降的情况很少见。若出现这种情况，应考虑选择其他支气管扩张剂。
