Intensive bronchial dilation test: A modified method for evaluating airway reversibility.

IF 2.1 Q3 ALLERGY

Asia Pacific Allergy Pub Date : 2025-06-01 Epub Date: 2025-02-05 DOI:10.5415/apallergy.0000000000000178

Yujuan Yang, Ningbo Tang, Yuemei Sun, Liping Liu, Jianwei Wang, Pengyi Yu, Jiayu Cao, Yu Zhang, Xicheng Song

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引用次数: 0

Abstract

Background: A negative bronchial dilatation test (BDT) does not fully reflect the status of airway irreversibility in patients with severe obstructive or mixed ventilation dysfunction due to severe bronchospasm, mucus blockage, or insensitivity to bronchodilators, which will directly affect the subsequent diagnosis and treatment of those patients.

Objective: We retrospectively examined the feasibility of using the "intensive bronchial dilation test" (IBDT) for excluding false-negative BDT.

Methods: We retrospectively analyzed the clinical data of 82 patients with severe obstructive or mixed ventilation dysfunction in the Allergy department of Yantai Yuhuangding Hospital of Qingdao University. After the BDT, they all inhaled the triple atomized drugs (2 mg salbutamol, 1 mg budesonide, and 0.25 mg ipratropium) every 20 minutes in one hour and the lung function test was performed 15 minutes later, which was named as IBDT. All patients received another lung function test after 2 to 4 weeks of regular anti-inflammatory treatment. We compared the improvement of lung function indexes and the proportion of patients with reversible airway obstruction between BDT, IBDT, and 2 to 4 weeks of treatment groups.

Results: The lung function indexes were significantly improved after the IBDT than those after the BDT (all P values < 0.01) and the number of patients with reversible airway obstruction significantly increased from 31 to 61 after the IBDT (P < 0.001), but the proportion of patients with reversible airway obstruction after the IBDT did not differ from that of patients with reversible airway obstruction after 2 to 4 weeks of treatment. The accuracy and sensitivity of the IBDT in evaluating airway reversibility reached 91.46% and 89.71%, respectively, both of which were significantly higher than for the BDT (54.88% and 45.59%, respectively).

Conclusion: Our finding suggests that IBDT can more accurately and rapidly evaluate airway reversibility in patients with severe obstructive or mixed ventilation dysfunction when compared to BDT.

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强化支气管扩张试验：一种评估气道可逆性的改进方法。

背景：支气管扩张试验（BDT）阴性不能完全反映严重支气管痉挛、粘液堵塞或对支气管扩张剂不敏感导致的严重阻塞性或混合性通气功能障碍患者的气道不可逆性状态，这将直接影响患者的后续诊断和治疗。目的：回顾性探讨“强化支气管扩张试验”（IBDT）用于排除假阴性支气管扩张试验的可行性。方法：回顾性分析青岛大学烟台玉皇顶医院变态反应科收治的82例重度阻塞性或混合性通气功能障碍患者的临床资料。BDT后，患者在1小时内每20分钟吸入三雾化药物（沙丁胺醇2 mg、布地奈德1 mg、异丙托品0.25 mg）， 15分钟后进行肺功能检查，称为IBDT。所有患者在常规抗炎治疗2至4周后接受另一次肺功能检查。我们比较了BDT组、IBDT组和2 ~ 4周治疗组肺功能指标的改善情况和可逆性气道阻塞患者的比例。结果：IBDT术后肺功能指标较BDT术后明显改善（P值均< 0.01），出现可逆性气道阻塞的患者从31例显著增加至61例（P < 0.001），但IBDT术后出现可逆性气道阻塞的患者比例与治疗2 ~ 4周出现可逆性气道阻塞的患者比例无显著差异。IBDT评估气道可逆性的准确性和敏感性分别达到91.46%和89.71%，均显著高于BDT（54.88%和45.59%）。结论：我们的研究结果表明，与BDT相比，IBDT可以更准确、更快速地评估严重阻塞性或混合性通气功能障碍患者的气道可逆性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Asia Pacific Allergy ALLERGY-

CiteScore

2.50

自引率

5.90%

发文量

期刊介绍： Asia Pacific Allergy (AP Allergy) is the official journal of the Asia Pacific Association of Allergy, Asthma and Clinical Immunology (APAAACI). Although the primary aim of the journal is to promote communication between Asia Pacific scientists who are interested in allergy, asthma, and clinical immunology including immunodeficiency, the journal is intended to be available worldwide. To enable scientists and clinicians from emerging societies appreciate the scope and intent of the journal, early issues will contain more educational review material. For better communication and understanding, it will include rational concepts related to the diagnosis and management of asthma and other immunological conditions. Over time, the journal will increase the number of original research papers to become the foremost citation journal for allergy and clinical immunology information of the Asia Pacific in the future.