【摘要】 目的　探讨咳喘老年人的气道反应性特点 ,为老年人气道高反应性 (BHR)在临床上的应用提供依据。　方法　临床疑诊为气道反应性增高且肺功能正常或接近正常的老年患者 187例 ,以二磷酸组织胺吸入作支气管激发试验 ,评价其气道高反应性。　结果　激发试验阳性者 6 9例 ,阳性率为 36 9% ,其中男性 38例 ,女性 31例。BHR的程度分布 :极轻度者 2 2例 ,占 31 9% ;轻度者 30例 ,占 43 5 % ;中度者 17例 ,占 2 4 6 % ;本组病例中未见重度BHR者。第 1秒用力呼气量 (FEV1)占预计值的百分率与使FEV1下降 2 0 %所需组织胺的累积激发剂量 (PD2 0 FEV1 His)呈低度正相关 (r =0 2 77,P <0 0 5 )。　结论　本组疑诊为BHR的老年患者其支气管激发试验阳性率较低 ;气道反应性增高程度以极轻度和轻度为主 ,基础肺功能与气道反应性增高在老年患者中呈低度正相关 ,基础肺功能损害较重者其气道反应性增高也较明显更多还原

【Abstract】 Objective The severity of bronchial hyperresponsiveness (BHR) is closely related to the severity of bronchial inflammation. BHR has been studied widely in adults and children, but less in the elderly. The purpose of this study is to summarize the characteristics of BHR in the elderly. Methods A total of 187 elderly subjects (95 males, 92 females) aged ≥ 60 years old (66.1±5.2 years old) were studied. They were clinically suspected with BHR (wheezing or chronic cough for at least 3 consecutive weeks, excluding laryngeal and lung diseases) but lung functions were normal or closed to normal (baseline FEV 1 ≥70% prediction). Bronchial provocation test with histamine were applied to access the bronchial reactivity. Provocative dose of histamine that makes FEV 1 decreasing by 20% (PD 20FEV 1-His) were used to evaluate the BHR severity. Results The positive rate of BHR was 36.9%, and slightly higher in male than female (40.0% vs 33.7%, P>0.05). The BHR distribution was slight 31.9%, mild 43.5%, moderate 24.6%, no severe BHR were found in this study, showing less correlation between the percentage of predicted FEV 1 and the PD 20FEV 1-His in the elderly (r=0.277, P<0.05). It indicated that the more the impairment of lung function, the higher the BHR. Conclusions The positive rate of BHR is lower and the BHR is milder in the elderly subjects. BHR in the elderly needs further study.更多还原