The Clinical Evaluation Of The Detection Of Bronchial Responsiveness By Astograph

OBJECTIVE: Asthma is a prevalent disease and Bronchial hyperresponsiveness(BHR) is one of the key characteristic of asthma. The provocative test is the vital measurement to estimate BHR. The method of astograph was founded by Impulse oscillation technique(IOS) and designed to evaluate BHR by continuously collecting pulmonary resistance. In our research ,Astograph J-21 was used to evaluate the clinical significance of BHR .METHODS: In the first part,100 persistent cough patients of 301 hospital from 2005 Oct to 2006 Jan were evaluated by astograph J-21. In the second part, the respiratory and provocative indexes of 20 asthma patients,52 CVA patients and 35 healthy person were evaluated. The regression analysis of respiratory and provocative indexes between 52 CVA patients and 20 asthma patients were conducted by SPSS 11.0 software.RESULTS : The results of the first part showed that there were 52 positive patients, 48 negative patients in the Provocative test and the overall positive rate is 52% .To compare the pulmonary indexes, we found the remarked significance(p <0.01) between the two groups on the pulmonary index FEV1,FEV1%,PEF,MMEF,P₂₅,P₅₀ and P₇₅,except FVC index. The significance was more clearly between lower air tract indexes ,such as P50 and MMEF. Moreover, more prevalent difference was found in provocative test, such as index Grs(p <0.01) and the basic resistance(p <0.05). The stepwise regression was conducted by using the pulmonary index to be the independent variables and the provocative index to be the dependent variables. The results showed the indexes, such as P50,P75,MMEF,PEF, who represent the lower airway function had regression with the provocative index.In the second part, the respiratory and provocative index of 20 asthma patients,52 CVA patients and 35 healthy person were evaluated. Among the three groups, remarked significance(P<0.01) were found between the healthy group , asthma patients and the CVA group respectively. The fact hinted that the difference of pulmonary function existed between the healthy people and asthma patients, CVA group and the asthma group. Furthermore, the respiratory indexes ,such as FEV1%,P₂₅,P₅₀ and P₇₅ ,were found remarked significance(P<0.05)between asthma group and CVA patients; the provocative indexes, such as Grs, basic consistence, were found remarked significance(P<0.01)between asthma and CVA, healthy and CVA patients. The fact was matched with the clinical performance of CVA disease.The regression analysis of 52 CVA patients showed that FEV1 and BMI have regressions with several provocative indexes, such as Cmin with P50(regression rate 19.504),Dmin with BMI(-0.224),FEV1(0.047) and PD35 with BMI(-0.615),FEV1(0.156). The regression analysis of 20 asthma patients showed that BMI and sex have regressions with several indexes, such as Dmin with BMI(-0.042), basic resistance with sex(1.954).The result revealed that to the CVA patients, BMI and FEV1 were more sensitive indexes to foresee CVA disease; to the Asthma patients, we should pay more attention to the BMI index. Besides, the analysis showed that 90% asthma patients have the Dmin value lower than 1 unit;80% CVA patients have Dmin lower than 3 unit, which remind us that the patient whose Dmin lower than 1 unit seems to have asthma disease.CONCLUSIONS:â‘ The positive rate of provocative test is 52% by astograph which is similar to foreign reports and matched with other provocative methods;â‘¡The patients with persistent cough and positive provocative results are more possibly to be the CVA patients;â‘¢In pulmonary indexes, remarked significance (P<0.01) was found between the healthy and the asthma,the healthy and CVA patients respectively. The CVA patients and the asthma group were also founded significance(P<0.05) in lower airway index, P50 and P75 ;â‘£The remarked significance (P<0.01)was found between the healthy and the asthma, between the CVA and the asthma patients;⑤To the CVA patients, BMI and FEV1 were found having regressions with provocative indexes;â‘¥To the Asthma patients, BMI was found related to several provocative indexes;⑦The Dmin of 90% Asthma patients was lower than 1 unit and 80% CVA patients have the Dmin lower than 3 units, which reveal that patients whose Dmin lower than 1 unit may possibly to be a asthma patients.