目的：探讨高渗盐水激发试验在哮喘的诊断价值,了解其诊断的敏感性和特异性。方法对已经确诊的稳定期的哮喘患者行乙酰甲胆碱激发试验及高渗盐水激发试验探讨其敏感性；对具有气道高反应性的常见疾病,慢性支气管炎,无哮喘症状的过敏性鼻炎及非慢性咳嗽变异性哮喘的慢性咳嗽患者行两种激发试验了解其特异性。结果对于稳定期的哮喘患者,乙酰甲胆碱激发试验的阳性率较高达到90%(27/30),而在高渗盐水激发试验阳性率为56%(17/30)。无喘息症状的慢性支气管炎患者、无气道症状的过敏性鼻炎患者及非咳嗽变异性哮喘的慢性咳嗽患者的阳性率在乙酰甲胆碱激发试验分别为63%(19/30),53%(16/30),36%(11/30),在高渗盐水激发试验分别为13%(4/30)6%(2/30)3%(1/30)。结论乙酰甲胆碱激发试验敏感性高,特异性不足,高渗盐水激发试验特异性高而敏感性不足,高渗盐水激发试验有望作为乙酰甲胆碱激发试验的补充,在哮喘诊断中有望发挥独特作用。%Objective To investigate the diagnosis value of 10% hypertonic saline challenge on asthma. Methods This study selected 30 patients with asthma, 30 patients with allergic rhinitis without wheeze symptom, and 30 chronic bronchitis patients with smoking history and 30 chronic cough patients excluding cough variability asthma. All patients were performed methacholine airway challenge test and hypertonic saline airway challenge test. Results In the asthma group, the sensitivity of methacholine airway challenge test and hypertonic saline airway test were 90% and 56% respectively. For these patients with allergic rhinitis without wheeze symptom, chronic bronchitis patients with smoking history and chronic cough patients excluding cough variability asthma, the rate of positive test result was 63% (19/30), 53% (16/30) and 36% (11/30) in methacholine airway challenge test, and 13% (4/30), 6% (2/30) and 3% (1/30) in hypertonic saline airway challenge test respectively. Conclusion Hypertonic saline is less sensitive but more specific than methacholine challenge in the diagnosis of patients with asthma.
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