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男性患者肺活量计操作诱发的支气管收缩:一例报告

Bronchoconstriction Induced by Spirometric Maneuvers in a Male Patient: A Case Report.

作者信息

Knaz Asma, Abdesalem Mariem, Ben Bdira Baraa, Omrane Asma, Abdelghani Ahmed, Ben Saad Helmi

机构信息

Pneumology Department, Farhat Hached Hospital, Sousse, Tunisia.

Research Laboratory "Heart Lung Interaction (LR14ES05)," University of Sousse, Tunisia.

出版信息

Am J Mens Health. 2025 May-Jun;19(3):15579883251339559. doi: 10.1177/15579883251339559. Epub 2025 May 24.

DOI:10.1177/15579883251339559
PMID:40413574
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12103678/
Abstract

Spirometry-induced bronchoconstriction (SIB) refers to the paradoxical narrowing of the airways triggered by deep inhalation (DI) during spirometry testing. This response is atypical but can occur in subjects with heightened airway sensitivity, such as those with asthma. The present case report described a male patient who developed SBI in response to DI during spirometric maneuvers. A 34-year-old male patient with personal (i.e., rhinitis) and family allergy consulted our pulmonary department for recurrent wheezing dyspnea associated with exertional dyspnea level 2 according to the modified Medical Research Council dyspnea scale. Asthma diagnosis was suspected and a spirometry test was required. During five consecutive spirometric efforts, the patient developed a SIB with forced expiratory volume in one second (FEV) decreases (in mL and % of initial value [%]) of 50 mL (1%), 270 mL (8%), 480 mL (14%), and 600 mL (18%), respectively. Following the spirometry tests, the patient presented symptoms such as wheezing, shortness of breath, and chest tightness. The bronchodilator test (i.e., 400 µg of short-acting bronchodilator) was clinically significant with an increase of FEV by 1,260 mL (40%) (FEV passed from 2.80 L [65%] to 4.06 L [95%]). An alleviation of symptoms was noted, which supports the diagnosis of SIB. Clinicians should exercise caution when asking asthmatic patients to repeatedly perform DI for spirometry testing.

摘要

肺量计诱发的支气管收缩(SIB)是指在肺量计测试期间,深吸气(DI)引发的气道反常狭窄。这种反应不典型,但可发生于气道敏感性增高的受试者,如哮喘患者。本病例报告描述了一名男性患者,其在肺量计操作期间因深吸气而发生SIB。一名有个人(即鼻炎)和家族过敏史的34岁男性患者因反复喘息性呼吸困难伴根据改良医学研究委员会呼吸困难量表评定的2级劳力性呼吸困难,前来我院呼吸科就诊。怀疑为哮喘,需要进行肺量计测试。在连续五次肺量计检查中,患者发生了SIB,一秒用力呼气容积(FEV)分别下降了50 mL(1%)、270 mL(8%)、480 mL(14%)和600 mL(18%)(以毫升计及相对于初始值的百分比 [%])。肺量计测试后,患者出现喘息、呼吸急促和胸闷等症状。支气管扩张试验(即400 μg短效支气管扩张剂)具有临床意义,FEV增加了1260 mL(40%)(FEV从2.80 L [65%]升至4.06 L [95%])。症状有所缓解,这支持了SIB的诊断。临床医生在要求哮喘患者反复进行深吸气以进行肺量计测试时应谨慎。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c551/12103678/9f0763853cbb/10.1177_15579883251339559-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c551/12103678/9f0763853cbb/10.1177_15579883251339559-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c551/12103678/9f0763853cbb/10.1177_15579883251339559-fig1.jpg

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