The prevalence of bronchial asthma has been rising annually, yet primary healthcare institutions still face difficulties in early diagnosis and treatment. Bronchial provocation test (BPT) is an important diagnostic tool with significant value. Although BPT is widely used both domestically and internationally, its prevalence in Guangdong Province remains low and development is uneven. Understanding the current status and issues of BPT implementation in Guangdong will help improve early diagnosis and management of bronchial asthma.

To investigate the current status of bronchial challenge tests in Guangdong Province and analyze the issues that need improvement during its development.

This study used a convenience sampling method to select 236 medical institutions from 21 cities in Guangdong Province, including 19 primary hospitals, 69 secondary hospitals, and 148 tertiary hospitals. Each institution appointed one staff member from the respiratory department or pulmonary function laboratory to complete a questionnaire. The questionnaire covered hospital information, years of experience in performing bronchial challenge tests, equipment used, challenge agents, adverse event management, staff training, quality control measures, and knowledge of bronchial challenge test protocols.

The study revealed that only 57.63% of the 236 medical institutions surveyed had implemented bronchial challenge tests, with most being tertiary hospitals and some secondary hospitals, while primary hospitals had very low rates of implementation. Of the institutions conducting the tests, 77.94% used quantitative nebulization, and 97.79% used imported equipment, though the use of domestic brands had increased significantly (13.97%). In terms of quality control, only 66.18% of institutions performed regular calibration of nebulization devices, indicating a lack of standardized quality control measures. There were also discrepancies in healthcare workers' understanding of bronchial challenge test-related knowledge, particularly in the recognition of positive indicators and standards for positive results.

The prevalence of bronchial challenge tests in Guangdong Province remains low, and the implementation is uneven, with primary hospitals not conducting these tests at all. There is a lack of standardization in calibration, methods, quality control, and interpretation of results. Pulmonary function staff urgently need standardized training to improve these areas.

支气管哮喘的患病率逐年上升，但基层医疗机构仍面临早期诊断和治疗困难。支气管激发试验（BPT）作为重要的诊断工具，意义重大。尽管BPT在国内外应用广泛，但广东省的普及率仍较低且发展不平衡。了解广东省内BPT的应用现状和问题，有助于提升支气管哮喘的早期诊断和管理。

了解广东省BPT的应用现状，并分析其在发展过程中亟需改进的问题。

采用便利抽样法，选取2024年广东省21个地级市的236家医疗机构，涵盖一级、二级和三级医院，分别为19家、69家和148家。每家医疗机构选派1名呼吸内科或肺功能室的工作人员填写问卷，问卷内容包括医院的基本信息、BPT的开展年限、设备使用、激发试剂、不良反应、培训需求、质量控制措施及对BPT相关知识的掌握情况。

236家医疗机构中有136家（57.63%）医疗机构开展了BPT，其中三级医院109家（80.15%）、二级医院27家（19.85%），一级医院均未开展；BPT开展的中位年限为6.00（2.25，10.00）年。136家开展BPT的医疗机构中，133家（97.79%）医院激发设备是进口品牌，国产设备的使用比例为13.97%（19/136）；106家（77.94%）医院使用定量雾化吸入法；乙酰甲胆碱作为主要试剂的使用率为83.09%（113/136）。在100家未开展BPT的医院中，60.00%（60/100）的医院受访者认为限制BPT开展的主要因素是缺乏设备。在质量控制方面，仅66.18%（90/136）的医院对雾化设备进行定期校准。97.06%（132/136）的医院受访者表示其熟悉BPT的相关知识。BPT过程中，常见的不良反应包括咳嗽（95.59%）、喘息（86.03%）、胸闷（69.12%）。仅16.91%（23/136）的医院受访者对判断指标有正确认知，只有5.88%（8/136）的医院受访者对阳性判断标准有清晰的了解。

广东省BPT的普及率仍较低，开展情况不平衡，基层医院尚未开展。BPT的定标、方法、质控及结果解读缺乏规范，肺功能从业人员亟需进行规范化培训。