Kabondo P, Orehek J
Bull Eur Physiopathol Respir. 1977 Nov-Dec;13(6):829-36.
Our purpose was to determine whether, in patients with airway obstruction, the change in the forced expiratory volume in one second (FEV1) which occurs after a bronchodilator drug, is helpful in differentiating asthma from chronic bronchitis. Two groups of patients (48 with asthma and 42 with chronic bronchitis) having a comparable level of initial airway obstruction were selected according to clinical criteria. After salbutamol (200 microgram inhaled) the number of subjects showing a change in FEV1 of at least 20 percent of its initial value or 10 percent of its predicted value was significantly greater (p less than 0.01) in the asthmatic than in the bronchitic group. Lesser changes in FEV1 did not significantly separate the two groups. When the changes in FEV1 were expressed as percentages of both initial and predicted values, the number of positive responses increased in the asthmatic group. However, there were still 20 asthmatics with little or no change in FEV1 after salbutamol who could not be distinguished from the patients with chronic bronchitis. From these data we conclude that, in patients with airway obstruction, a large bronchodilator-induced change in FEV1 strongly suggests the diagnosis of asthma but that the presence of "irreversible" airway obstruction does not disprove it.
我们的目的是确定在气道阻塞患者中，支气管扩张剂用药后一秒用力呼气容积（FEV1）的变化是否有助于鉴别哮喘与慢性支气管炎。根据临床标准，选择了两组初始气道阻塞程度相当的患者（48例哮喘患者和42例慢性支气管炎患者）。吸入沙丁胺醇（200微克）后，FEV1变化至少达到其初始值的20%或预测值的10%的哮喘患者人数显著多于（p<0.01）慢性支气管炎组。FEV1较小的变化并不能显著区分这两组。当FEV1的变化以初始值和预测值的百分比表示时，哮喘组的阳性反应数量增加。然而，仍有20例哮喘患者在吸入沙丁胺醇后FEV1变化很小或无变化，无法与慢性支气管炎患者区分开来。从这些数据我们得出结论，在气道阻塞患者中，支气管扩张剂引起的FEV1大幅变化强烈提示哮喘诊断，但“不可逆”气道阻塞的存在并不能排除哮喘诊断。
