Clinical value of hypertonic saline bronchial provocation test in predicting exercise-induced asthma
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摘要: 目的 探讨高渗盐水支气管激发试验预测运动性哮喘(EIA)的临床价值.方法 对在本院就诊的36例年轻男性哮喘患者进行支气管激发试验,依次进行高渗盐水激发试验(吸入4.5％高渗盐水)、运动激发试验(间隔24h)及乙酰甲胆碱(MCh)激发试验,并对3者间的相关性进行评价.结果 对高渗盐水有高反应性(HS-AHR)的哮喘患者运动后1秒用力呼气量(FEV1)下降的最大值显著高于无HS-AHR患者,运动与高渗盐水所诱发的AHR严重程度具有显著相关性.在预测EIA的价值上,高渗盐水激发试验比MCh激发试验具有更高的特异性(71.4％:42.9％).当临界值MCh-PC20≤1 mg/mL(中度～重度AHR)时,二者对于判断EIA的特异性具有可比性(71.4％:71.4％),但高渗盐水激发试验对于判断EIA的敏感性低于MCh试验,同时,MCh试验阳性似然比高于HS激发试验,而阴性似然比却更低.结论 在预测EIA的价值上,高渗盐水激发试验比MCh激发试验具有更高的特异性,但敏感性较低,而在中度AHR的临界值方面,MCh激发试验能更好地预测EIA.
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