Williamson H A
J Fam Pract. 1987 Sep;25(3):251-6.
Acute bronchitis is a common syndrome characterized by upper respiratory tract infection accompanied by productive cough in persons without chronic lung disease. As a first step in investigating the potential role of pulmonary airflow disturbances in acute bronchitis, 27 adult patients with acute bronchitis performed serial pulmonary function tests and daily peak flow measurements and completed daily symptom diaries. Eleven patients (40 percent) had a forced expiratory volume of the first second (FEV1) at entry less than 80 percent of predicted. Mean FEV1, forced midexpiratory flow rate (FEF25-75), and peak flow measures showed steady improvement over the five-week period. Differences between initial and final flow rates were statistically significant. These changes were particularly evident when two groups were created by stratifying by "abnormal" (FEV1 less than or equal to 80 percent predicted) and "normal" (FEV1 greater than 80 percent predicted) initial FEV1. Total duration of cough and subjective ratings of cough severity were not predicted by initial FEV1, but work absence was significantly higher in the abnormal group. The finding of reversible airway obstruction suggests a role for bronchospasm in many cases of acute bronchitis and calls for further research regarding proof of rapid reversibility and treatment with bronchodilators.
急性支气管炎是一种常见综合征，其特征为上呼吸道感染，且在无慢性肺部疾病的患者中伴有咳痰性咳嗽。作为研究肺气流紊乱在急性支气管炎中潜在作用的第一步，27例成年急性支气管炎患者进行了系列肺功能测试和每日峰值流量测量，并完成了每日症状日记。11例患者（40%）在入组时第一秒用力呼气量（FEV1）低于预测值的80%。在为期五周的时间里，平均FEV1、用力呼气中期流速（FEF25-75）和峰值流量测量值均显示出稳步改善。初始和最终流速之间的差异具有统计学意义。当根据初始FEV1将患者分为“异常”（FEV1小于或等于预测值的80%）和“正常”（FEV1大于预测值的80%）两组时，这些变化尤为明显。咳嗽的总持续时间和咳嗽严重程度的主观评分并不能由初始FEV1预测，但异常组的缺勤率显著更高。可逆性气道阻塞的发现表明，支气管痉挛在许多急性支气管炎病例中起作用，并需要进一步研究快速可逆性的证据以及使用支气管扩张剂进行治疗。
