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。
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.
出处
《上海交通大学学报（医学版）》
CSCD
北大核心
2017年第7期959-963,共5页
Journal of Shanghai Jiao tong University:Medical Science
基金
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)~~
