Objective：The current study aimed to compare and analyze the pulmonary function and eosinophil inflammation parameters between patients with chest tightness variant asthma(CTVA)and those with typical classical(CA)for further recognition about the atypical bronchial asthma with chest tightness as the main manifestation. Methods：A total of 55 patients with CTVA and 94 patients with CA who were diagnosed and treated in the Outpatient Department between October 2019 and October 2021 were retrospectively analyzed(the airway provocation test was positive in both groups，and the medical history and clinical characteristics met the diagnostic criteria of asthma). The pulmonary function test，exhaled nitric oxide，blood eosinophils，specific and total IgE levels were analyzed and compared between the two groups. Results：There was no significant difference in age，sex ratio，allergic history， allergic rhinitis，nasal polyps，eczema and chronic urticarial between the CTVA and CA groups(P ＞ 0.05). The patients with mild impairment of the small airway function in the CTVA group(CTVA group：CA group=27.27%：43.62%)were less than those of the CA group(P=0.047). There was no significant in the moderate to severe impairment of small airway function，the percentage of increased airway resistance，and RV/TLC between the two groups(P ＞ 0.05). There was no significant difference in ventilatory function[forced vital capacity(FVC)、forced expiratory volume in one second/forced vital capacity(FEV1/FVC)、peak expiratory flow(PEF)]or pulmonary reserve[maximal voluntary ventilation(MVV)]between the two groups(P ＞ 0.05). Peripheral blood eosinophils were significantly lower in the CTVA group[absolute：(0.16 ± 0.15)×109 /L，percentage：(2.50 ± 2.25)%]than in the CA group[absolute： (0.27 ± 0.25)×109 /L，percentage(4.0 ± 3.8)%，with a significant difference[P=0.017(absolute)，P=0.031(percentage)]. The positive rate of specific IgE in the CTVA group(23.8%)was lower than that in the CA group(48.5%)(P=0.043)，and the total IgE level in peripheral blood in the CTVA group[86.7(24.7，172.9)kU/L]was significantly lower than that in the CA group[181.2(97.25， 454.8)kU/L]，with a significant difference(P=0.009). The mean concentration of exhaled nitric oxide in the CTVA group(29 ppb)was significantly lower than that in the CA group(79 ppb)，with a significant difference(P=0.027). Conclusion：The rate of mild obstruction of the small airway in CTVA patients was smaller than that in CA patients，the rate of moderate and severe obstruction of the small airway was equal to that in CA patients，and peripheral blood eosinophil levels were lower than in those with CA.
