Changes Of FEV1, FVC And Dyspnea Of Patients With COPD Before And After Bronchial Dilation Test

Background and objective:The pulmonary function test is the main basis for the diagnosis of COPD,usually reversible expiratory airflow limitation as the main basis for identification ofCOPD and asthma, and after bronchodilation test with a second forced expiratoryvolume percentage of (FEV1%) as the classification of severity of COPD standard.Reversible airflow limitation mainly by the degree of bronchial dilation test beforeand after the forced expiratory volume in one second (FEV1) change is represented,usually considered reversible airflow limitation is bigger, patients with bronchodilatorresponse is better, patients use drug therapy effect is better, on the contrary, if thereversible airflow limitation in patients with smaller, the treatment effect is relativelypoor. In clinical work, we often encounter such problems: some mild patients withbronchodilator response is not good, and some severe or extremely severe patients ofbronchodilators and good response, indicating the severity grading and bronchodilatortherapy effect is not completely consistent. At the same time, we often encounter sucha situation, bronchial dilation test before and after the change, the changes of FEV1and forced vital capacity, maximum peak expiratory flow is not uniform, somepatients with FEV1did not appear to rise apparently, even decreased, and the patient’s own symptoms have obvious improvement. We thus propose the question, FEV1usedalone as an indicator to judge at all levels in patients with diastolic reaction ofbronchial whether exist deficiencies, which indicators can serve as a good supplement?The domestic and international research present: for the patients with differentseverity of COPD, before and after inhalation of bronchodilator, expiratory flow(FEV1) and lung volume (FVC) characteristics were significantly different, mainlywith the increased severity, flow rate changes more and more small, and the change oflung volume is more and more obvious, but has not proposed recognized can be usedas supplementary indexes.The main purpose of this study is a retrospective analysis of patients withdifferent severity of various indices of pulmonary function in bronchial dilation testbefore and after the changes, as well as the relationship between the changes of theseindices in patients with dyspnea change degree, which can select one or moreindicators, in order to better identify patients with diastolic reactive agent on thebronchial, and can be used to guide patients to use.Objects and methods.1.The general dataIn2012September---2014year in February,in the pulmonary function of theSecond Affiliated Hospital of Zhengzhou University Department of pulmonaryfunction examination, diagnosed181cases of stable COPD patients,139patientswere male, female42cases, mean age were between64.65+/-11.81years old.Thesepatients were all got the chest radiographic examination, electrocardiogram, heartcolour to exceed ruled out diseases such as heart failure, respiratory failure, trachealstenosis, and thoracic integrity defects, respiratory muscle is not sound, and nohistory of acute hospitalization within one month.2.Method.Lung function test: the research objects are pulmonary flow volume curve,bronchial relaxation tests。all patients underwent bronchial dilation test, the use of bronchodilators were recorded after the relief degree in patients with dyspnea;according to the severity of pulmonary function were divided into light,, heavy, verysevere in four groups of patients by comparison, the bronchial dilation test positiverates of bronchial dilation, correlation between the changes of PEF, FEV1, FVCgroups of patients and three variation rate before and after test, correlation changerate and three of the patients with dyspnea.Result1.Groups in various degree, FVC and FEV1had obvious difference before and afterdrug absorption (P <0.05), PEF in the three groups,which from mild to serious,allhad obvious difference before and after drug absorption (P <0.01), but the differencein the group of patients with very severe had no statistical significance (P>0.05).2.Changes of△FEV1,△FVC,△PEF: from the group of mild to very severe,△FEV1decreased gradually, the comparison among these groups, the difference wasstatistically significant (P<0.01); from mild to very severe,△FVC showed a risingtrend, the comparison among these groups, the difference was statistically significant(P<0.01); no significant change in△PEF, so there was no statistical differencebetween groups (P>0.05).3.Comparison of△F EV1%,△F VC%,△PEF%,△F VC%:with the severity, theyincreased by6.5+/-1.4%to19.3+/-2.7%, and the difference between groups wasmeaningful (P <0.01),△FEV1%gradually increased in mild, moderate, severegroups, but decreased obviously in the severe group, the groups differences weresignificative(P<0.01).4.Bronchial diastolic test positive rate gradually decreased from76.92%of themild to0%of the extremely severe.5.Improving breathing difficulties:Overall improved66.3%, obviously period by43.64%,were significantly greater than bronchi relaxation test positive which was at a rate of30.39%.Groups of dyspnea improved proportion in moderate, mild andextremely severe group were significantly greater than bronchi relaxation test positiverate(P<0.05).Conclusion1.FEV1as main observation indexes of bronchi relaxation test is an importantchecking method to judge the limitation of airflow reversibility, but there are obviousshortcomings2.The use of FEV1, FVC and dyspnea score reversible airflow limitation degree tocomprehensive evaluation is more accurate, comprehensive, objective, and can beused to determine the effectiveness of patients with bronchodilator.