Alternative methods for assessing bronchodilator reversibility in patients with severe chronic obstructive pulmonary disease
- VernacularTitle:不同指标对老年严重慢性阻塞性肺疾病患者吸入支气管舒张剂疗效的评价
- Author:
Rui CHEN
;
Rongchang CHEN
;
Lian CHEN
;
Jingping ZHENG
- Publication Type:Journal Article
- Keywords:
Pulmonary disease,chronic obstructive;
Dyspnea;
Evaluation stadies Bronehodilator agents
- From:
Chinese Journal of Geriatrics
2008;27(9):661-664
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the clinical significence of three alternative ways in assessing bronchodilator reversibility in patients with severe chronic obstructive pulmonary disease (COPD).Methods 18 clinically stable patients with severe COPD were collected. Pulmonary ventilation function and capacity of lung were measured after inhaling compound ipratropium bromide solution before and after nebulised saline, and at intervals. Expiratory flow limitation (EFL) was detected by negative expiratory pressure technique concurrently. Results Compared with placebo,bronchodilator caused a significant increase in forced expiratory volume in one second (FEV1)%Pred,forced vital capacity (FVC)%Pred and inspiratory capacity (IC)%Pred and a significant decrease in residual volume (RV)%Pred, functional residual capacity (FRC)% Pred and Borg scale. But there were no changes in total lung capacity (TLC)% Pred, 5-point EFL score and breathing pattern variables. The increase of IC was correlated with the reduction of Borg scale, but such correlation did not exist between the increase of FEV1 and the reduction of Borg scale. When ROC curve was applied to assess the significance of IC, 5-point EFL score and FEV1 in evaluating the effects of broncholilator,the area under curve (AUC) of which was 0. 868,0. 681 and 0. 557 respectively.Conclusions Compared with FEV1, IC has higher sensitivity and reliability to evaluate the clinical response of bronchodilator in patients with severe COPD. The 5-point EFL score is not an appropriate measurement of acute bronchodilator response.
