Abstract: Objective　To investigate the value of bronchial provocation test improved by inhaling hypertonic saline delivered by a quantitative nebulizer for the diagnosis of asthma in patients of all ages.Methods　1 094 outpatients suspected with asthma were enrolled from Guangdong Provincial Hospital of Chinese Medicine from February 2016 to February 2017.Based on the corresponding definitions of the WHO，they were divided into adolescent group（148 aged 5-17 years），young and middle-aged group（835 aged 18-59 years） and elderly group （111 aged 60 or over）．All of them underwent the conventional pulmonary function test and modified bronchial provocation test with inhaled hypertonic saline delivered by a quantitative nebulizer.The rate of patients with provoked positive bronchial reactions as well as incidence of adverse reactions were compared between the groups.Results　Totaled 164（16.2%） were found with provoked positive bronchial reactions，including 53 adolescent cases，93 young and middle-aged cases，18 elderly cases，accounting for 35.8%，11.1%，12.6% of the corresponding age group，respectively.The rate of patients with provoked positive bronchial reactions differed significantly between the 3 groups（χ2=60.201，P<0.01），to be specific，it was much higher in the adolescent group than that of other two groups（P<0.01）．The common adverse reactions secondary to the modified bronchial provocation test in all the patients were cough，chest tightness，dyspnea，wheezing，shortness of breath，pharyngeal itching，but no severe asthma attacks and other severe adverse reactions were found.The incidence of cough varied significantly between the groups（P<0.05），while that of chest tightness，dyspnea，wheezing，shortness of breath，pharyngeal itching and so on did not（P>0.05）．Conclusion　The modified bronchial provocation test is suitable for the diagnosis of asthma in patients of different ages，especially children.

Key words: Asthma；Nebulizers and vaporizers；Bronchial provocation tests；Saline solution, hypertonic

摘要： 目的　探讨定量雾化器改良高渗盐水支气管激发试验（简称改良激发试验）在不同年龄段哮喘诊断中的应用价值。方法　选取2016年2月—2017年2月在广东省中医院门诊就诊的因临床疑诊哮喘而行改良激发试验的患者1 094例，根据世界卫生组织（WHO）关于年龄段的划分标准，将患者分为5~17岁为少年组（n=148）、18~59岁为中青年组（n=835）、≥60岁为老年组（n=111）。患者均行常规肺功能检测及改良激发试验，比较不同年龄组改良激发试验阳性率和不良反应发生率。结果　患者改良激发试验阳性率为16.2%（164/1 094），其中少年组、中青年组、老年组改良激发试验阳性率分别为35.8%（53/148）、11.1%（93/835）和12.6%（18/111），3组改良激发试验阳性率比较，差异有统计学意义（χ2=60.201，P<0.01）。其中中青年组、老年组改良激发试验阳性率低于少年组（P<0.01）。3组患者行改良激发试验后，均未出现哮喘大发作等严重不良反应，常见的不良反应为咳嗽、胸闷、气紧、喘息、气促、咽痒等。3组胸闷、气紧、喘息、气促、咽痒、其他不良反应发生率比较，差异均无统计学意义（P>0.05）；3组咳嗽发生率比较，差异有统计学意义（P<0.05）。结论　改良激发试验适合不同年龄段哮喘患者的诊断，尤其适用于儿童。

关键词: 哮喘, 雾化器和汽化器, 支气管激发试验, 盐水, 高渗