Analysis of Bronchial Hyper-Reactivity in Patients with Lung Cancer_West China Medical Journal

Authors：

KE Hua

Department of Respiratory Medicine, the Seventh People′s Hospital of Chengdu City, Chengdu, Sichuan 610021, P. R. China;

Corresponding author：

Keywords：

肺癌; 气道高反应性; 肺通气; 易感因素

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【摘要】　目的　研究肺癌患者的气道高反应性和肺通气功能情况，并探讨其易感因素，为肺癌患者肺通气功能的临床评估提供依据。　方法　对2010年4月-2011年4月收治的40例肺癌患者（A组）进行术前肺功能检测及气管激发试验，选取同期的健康体检者40例做对照组（B组），并采用logistic逐步回归分析肺癌患者的气道高反应性的易感因素。　结果　 ①A组患者的用力肺活量、第1秒用力呼气容积（forced expiratory volume in one second，FEV1）、最高呼气流量（peak expiratory flow，PEF）以及最大呼气中期流量均小于B组，且差异有统计学意义（P=0.000）；②A组的FEV1估计异常人数和PEF估计异常人数均多于B组（P lt;0.05）；③A组组胺气道激发试验阳性者多于B组（χ2=5.000，P=0.025），且A组PD20FEV1低于对照组[分别为（4.69±0.82）、（8.32±1.43）μmol/L；t=13.930，P=0.000]；④logistic逐步回归分析表明影响A组患者的气道高反应性的因素为年龄、分型、TNM分期、病史、吸烟。　结论　肺癌气道反应性增高，且肺功能下降，由于肺癌气道高反应性的易感因素较多，因此需对合并因素较多者进行及时的预防，防止由于气道阻力增加和气道狭窄引起的胸闷、咳嗽、喘息和呼吸困难等症状。
【Abstract】　Objective　 To learn the condition of bronchial hyper-reactivity and pulmonary function in patients with lung cancer, and explore the risk factors for bronchial hyper-reactivity in order to provide clinical reference for pulmonary function evaluation in patients with lung cancer.　Methods　 Forty patients with lung cancer treated in our hospital from April 2010 to April 2011 (research group) took pulmonary function and tracheal stimulation tests before operation, and in the meanwhile, 40 healthy people were chosen as controls. The logistic regression analysis was employed to analyze the risk factors for bronchial hyper-reactivity.　Results　 The forced vital capacity, forced expiratory volume in one second (FEVl), peak expiratory flow (PEF) and maximal mid expiratory flow in the research group patients were all significantly lower than those in the control group patients (P=0.000). The number of patients with estimated FEVl and PEF abnormality in the research group was more than that in the control group (P=0.05). The number of patients positive in histamine bronchial provocation test in the research group was more than that in the control group (χ2=5.000, P=0.025), and the PD20FEV1 level of the research group was lower than that of the control group [(4.69±0.82) and (8.32±1.43) μmol/L; t=13.930, P=0.000]. Logistic regression analysis showed that the risk factors for bronchial hyper-reactivity in patients with lung cancer were age, type, TNM stage, history of lung cancer, and smoking.　Conclusions　 The airway reactivity elevates and the lung cancer pulmonary function decreases in lung cancer patients. Because there are many risk factors, prevention should be taken for patients with combined risk factors to avoid the occurrence of chest distress, cough, gasp and dyspnea caused by increased airway resistance and stricture.

Citation： KE Hua. Analysis of Bronchial Hyper-Reactivity in Patients with Lung Cancer. West China Medical Journal, 2011, 26(12): 1825-1827. doi: Copy

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1. 　Ward C, Reid DW, Orsida BE, et al. Inter-relationships between airway inflammation, reticular basement membrane thickening and bronchial hyper-reactivity to methacholine in asthma; a systematic bronchoalveolar lavage and airway biopsy analysis[J]. Clin Exp Allergy, 2005, 35(12): 1565-1567.
2. 　邵小玲. 肝素联合沐舒坦雾化吸入对慢性阻塞性肺病急性加重期的治疗[J]. 中华急诊医学杂志, 2007, 16(7): 756-758.
3. 　Kontakiotis T, Katsoulis K, Hagizisi O, et al. Bronchoalveolar lavage fluid alteration in antioxidant and inflammatory status in lung cancer patients[J]. Eur J Intern Med, 2011, 22(5): 522-526.
4. 　李秋华, 张宁苏. 408例原发性支气管肺癌患者症候演变与体力状况评分关系评价[J]. 甘肃中医学院学报, 2011, 28(3): 41-43.
5. 　米天明, 杨敬平. 应用肺功能检测在气道高反应诊断中的临床意义[J]. 临床肺科杂志, 2005, 10(1): 97.
6. 　张建刚, 何小林, 金辉. 气道高反应性疾病的病因分布及气道反应特征比较[J]. 现代实用医学, 2009, 21(10): 1091-1092.
7. 　Mastalerz L, Kasperkiewicz H. Effect of inhaled corticosteroids on small airway inflammation in patients with bronchial asthma[J]. Pol Arch Med Wewn, 2011, 121(7-8): 264-269.
8. 　强金伟, 周康荣, 蒋亚平, 等. 多排螺旋CT显示支气管与外周肺癌关系的价值[J]. 中华肿瘤杂志, 2004, 26(1): 45-48.
9. 　张敬东, 马祥兴. 孤立性肺结节与支气管关系的多层螺旋CT及病理对照研究[J]. 山东大学学报(医学版), 2010, 48(8): 91-95.
10. 　王文秀, 高江峰, 李云霄, 等. 肺癌患者空气贮留与肺功能指数的相关分析[J]. 河北医药, 2010, 32(18): 2486-2488.
11. 　王配配, 陈亚红, 齐永芬. 新型气体信号分子硫化氢对吸烟大鼠气道炎症和气道反应性的影响[J]. 中国呼吸与危重监护杂志, 2009, 8(4): 327-332.
12. 　毛陇均, 苏振丽. 老年性咳嗽变异性哮喘50例临床分析[J]. 航天航空医药, 2010, 21(9): 53-53.

West China Medical Journal

Analysis of Bronchial Hyper-Reactivity in Patients with Lung Cancer

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