上海交通大学学报（医学版）

上海交通大学学报（医学版） ›› 2017, Vol. 37 ›› Issue (7): 959-.doi: 10.3969/j.issn.1674-8115.2017.07.013

• 论著（基础研究） • 上一篇    下一篇

以呼吸困难为主诉的非器质性呼吸困难与支气管哮喘临床特点 对比研究

姚韬，敖敏，彭印印，江莉莎，郭述良   

  1. 重庆医科大学附属第一医院呼吸与危重症医学科，重庆 400016
  • 出版日期:2017-07-28 发布日期:2017-08-25
  • 通讯作者: 郭述良，电子信箱：GUOSL999@sina.com
  • 作者简介:姚韬（1991—），男，硕士生；电子信箱：yt_cqmujoy@126.com
  • 基金资助:
    国家自然科学基金（81570010）；国家临床重点专科专项经费资助项目（2012-649）

Comparison analysis of clinical characteristic of non-organic dyspnea and asthma both with a complaint of dyspnea#br#

YAO Tao, AO Min, PENG Yin-yin, JIANG Li-sha, GUO Shu-liang   

  1. Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
  • Online:2017-07-28 Published:2017-08-25
  • Supported by:
    National Nature Science Foundation of China, 81570010; National Key Clinical Specialty Foundation of China, 2012-649

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摘要： 目的 · 调查并对比分析以呼吸困难为主诉的非器质性呼吸困难和支气管哮喘的临床特征。方法 · 连续入选呼吸科门诊因呼吸 困难就诊的性别与年龄相匹配、身高与体质量相接近的非器质性呼吸困难和支气管哮喘患者各74 例作为调查对象，对 2 组患者行医 院焦虑抑郁量表、Nijmegen 症状学问卷和阿森斯失眠量表问卷调查，收集 2 组患者的症状描述语、临床症状、有效睡眠时间和肺功能 指标并作对比分析。结果 · 非器质性呼吸困难组倾向于精神心理方面的描述，支气管哮喘组侧重于气流受限的描述。非器质性呼吸困 难组多以心因性症状为主要表现，且睡眠时间少于支气管哮喘组（P<0.05）；焦虑评分、抑郁评分、Nijmegen 评分、阿森斯失眠问卷 评分、第 1 秒用力呼气容积、第 1 秒用力呼气容积占预计值的百分比、用力肺活量占预计值的百分比、一秒率均大于支气管哮喘组， 差异均有统计学意义（P<0.05）；用力肺活量2 组差异无统计学意义（P>0.05）。 结论 · 非器质性呼吸困难组的焦虑、抑郁、失眠比 支气管哮喘组更加明显，支气管哮喘组肺功能大多存在异常。鉴别两者时，临床医师需重视情绪、睡眠、躯体化症状等相关病史的询 问，行肺功能检查，认识两者的临床特点，降低漏诊率及误诊率。

关键词: &ensp, 呼吸困难, 支气管哮喘, 焦虑, 抑郁, 失眠

Abstract:

Objective · To investigate and compare the clinical characteristic of non-organic dyspnea and asthma both with complaint of dyspnea.  Methods · Seventy-four consecutive patients with non-organic dyspnea, and 74 age-, height-, weight and sex-matched patients with asthma were recruited for investigation in the study. The self-assessment surveys were conducted for the two groups by means of Hospital Anxiety and Depression Scale, Nijmegen Questionnaire and Athens Insomnia Scale. The words for describing dyspnea, clinical symptoms ,effective sleep hours and items of pulmonary function test were collected and analyzed  Results · Non-organic dyspnea patients tended to describe psychogenic aspects. Asthma patients tended to describe airflow limitation. Non-organic dyspnea group mainly performed psychogenic symptoms. The sleeping time in non-organic dyspnea group was significantly lower than that in asthma group(P<0.05). The score of anxiety, depression, Nijmegen Questionnaire, Athens Insomnia Scale, FEV1, FEV1%Pred, FVC%Pred, FEV1/FVC in non-organic dyspnea group were significantly higher than those in asthma group (P<0.05). There was no significant difference in FVC between two groups(P>0.05).  Conclusion · The non-organic group feel more anxiety, depressed and insomnic than the asthma group. Lung function test of asthma group is offen abnormal. To discriminate non-organic dyspnea with asthma, clinicians should pay more attention to emotion, sleep, somatoform symptoms, medical history and so on, and do pulmonary function test, improve the understanding of the characteristics of the two diseases, decrease misdiagnosis and wrong diagnosis.

Key words: dyspnea, asthma, anxiety, depression, insomnia