Changes of small airway function and diffusing capacity in patients with mild asthma before and after bronchial provocation test_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

 CHEN Yahong , YAO Wanzhen , LIU Xiaofang , LIANG Yanjing.

Department of Respiratory Medicine，The Third Hospital，Peking University.Beijing，100083，ChinaCorresponding author：CHEN Ya-hong，E-mail：henyahong@vip.sina.com;

Corresponding author：

CHEN Yahong, Email: chenyahong@vip.sina.com

Keywords：

Bronchial asthma; Bronchial hyperresponsiveness; Bronchial provocation test; Diffusing capacity; Small airway

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Objective To investigate the changes of small airway function and diffusing capacity in patients with mild asthma before and after bronchial provocation test (BPT).Methods BPT was performed in suspected asthma patients with chief complaints of paroxysmal wheeze,chest tightness and cough，but with normal chest X-ray and baseline pulmonary function.BPT positive group was regarded as asthma group，while BPT negative group as control group.Lung volume，ventilatory function and diffusing capacity were measured before and after BPT and compared between the asthma and control groups.Results （A）No statistical differences were found in FEV1%，FEV1/FVC，FVC%，VC%，TLC%，FRC%，RV%，RV/TLC between the asthma and control groups before BPT.FEV1/FVC and FVC% were significantly decreased (all P lt;0.01)，while FRC% (P lt;0.05)，RV% (P lt;0.01) and RV/TLC (P lt;0.01) increased significantly in the asthma group after BPT compared with the control group.The decline rate of FEV1/FVC and FVC% and the increase rate of TLC%，RV%，RV/TLC were significantly higher in the asthma group than those in the control group (all P lt;0.01).（B）Compared with the control group，FEF25%-75% (P lt;0.05)，Vmax75% (P lt;0.01) and Vmax50% (P lt;0.05) were significantly lowered before BPT，while the above parameters and Vmax25% were significantly decreased after BPT in the asthma group (all P lt;0.01).The decline rate of FEF25%-75%，Vmax75%，Vmax50% and Vmax25% was significantly higher in the asthma group than those in the control group (all P lt;0.01).（C）There was no statistical difference in DLCO in both groups before and after BPT.Conclusions Patients with mild asthma had small airways impairment before BCT which further declined after BPT.However,no impairment of diffusion capacity was found before or after BPT.

Citation： CHEN Yahong,YAO Wanzhen,LIU Xiaofang,LIANG Yanjing.. Changes of small airway function and diffusing capacity in patients with mild asthma before and after bronchial provocation test. Chinese Journal of Respiratory and Critical Care Medicine, 2007, 6(1): 3-7. doi: Copy

1.	中华医学会呼吸病学会哮喘学组.支气管哮喘防治指南（支气管哮喘的定义、诊断、治疗及教育和管理方案）.中华内科杂志，2003，42：817-822.
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11.	van der Lee I，Zanen P，van den Bosch JM，et al.Pattern of diffusion disturbance related to clinical diagnosis：The K(CO) has no diagnostic value next to the DL(CO).Respir Med，2006，100：101-109.
12.	Ulrik CS，Backer V.Nonreversible airflow obstruction in life-long nonsmokers with moderate to severe asthma.Eur Respir J，1999，14：892-896.
13.	Hudon C，Turcotte H，Laviolette M，et al.Characteristics of bronchial asthma with incomplete reversibility of airflow obstruction.Ann Allergy Asthma Immunol，1997，78：195-202.
14.	Gelb AF，Licuanan J，Shinar CM，et al.Unsuspected loss of lung elastic recoil in chronic persistent asthma.Chest，2002，121：715-721.
15.	Collard P，Njinou B，Nejadnik B，et al.Single breath diffusing capacity for carbon monoxide in stable asthma.Chest，1994，105：1426-1429.
16.	刘春涛，何权瀛.2004中国哮喘论坛专家共识.中国呼吸与危重监护杂志，2004，3：204-208.

1. 中华医学会呼吸病学会哮喘学组.支气管哮喘防治指南（支气管哮喘的定义、诊断、治疗及教育和管理方案）.中华内科杂志，2003，42：817-822.
2. 四川省医学会呼吸病专业委员会.新指南，新起点.中国呼吸与危重监护杂志，2003，2：3-13.
3. Shaw RJ，Djukanovic R，Tashkin DP，et al.The role of small airways in lung disease.Respir Med，2002，96：67-80.
4. Maselli R，Paciocco G.Asthma：pathophysiology of the bronchial obstruction.Allergy，2000，55 Suppl 61：49-51.
5. Boulet LP，Lemiere C，Archambault F，et al.Smoking and asthma：clinical and radiologic features，lung function，and airway inflammation.Chest，2006，129：661-668.
6. Sciurba FC.Physiologic similarities and differences between COPD and asthma.Chest，2004，126：117S-124S.
7. King GG，Carroll JD，Muller NL，et al.Heterogeneity of narrowing in normal and asthmatic airways measured by HRCT.Eur Respir J，2004，24：211-218.
8. Parker AL，Abu-Hijleh M，McCool FD.Ratio between forced expiratory flow between 25% and 75% of vital capacity and FVC is a determinant of airway reactivity and sensitivity to methacholine.Chest，2003，124：63-69.
9. Currie GP，Jackson CM，Lee DK，et al.Determinants of airway hyperresponsiveness in mild asthma.Ann Allergy Asthma Immunol，2003，90：560-563.
10. 姚婉贞，赵鸣武，韩荣藓.以肺功能实测值作为支气管激发试验的判定指标比较分析.中华结核和呼吸杂志，1994，17：220-222.
11. van der Lee I，Zanen P，van den Bosch JM，et al.Pattern of diffusion disturbance related to clinical diagnosis：The K(CO) has no diagnostic value next to the DL(CO).Respir Med，2006，100：101-109.
12. Ulrik CS，Backer V.Nonreversible airflow obstruction in life-long nonsmokers with moderate to severe asthma.Eur Respir J，1999，14：892-896.
13. Hudon C，Turcotte H，Laviolette M，et al.Characteristics of bronchial asthma with incomplete reversibility of airflow obstruction.Ann Allergy Asthma Immunol，1997，78：195-202.
14. Gelb AF，Licuanan J，Shinar CM，et al.Unsuspected loss of lung elastic recoil in chronic persistent asthma.Chest，2002，121：715-721.
15. Collard P，Njinou B，Nejadnik B，et al.Single breath diffusing capacity for carbon monoxide in stable asthma.Chest，1994，105：1426-1429.
16. 刘春涛，何权瀛.2004中国哮喘论坛专家共识.中国呼吸与危重监护杂志，2004，3：204-208.

Chinese Journal of Respiratory and Critical Care Medicine

Changes of small airway function and diffusing capacity in patients with mild asthma before and after bronchial provocation test

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