慢性阻塞性肺疾病急性加重期患者治疗前后呼出气冷凝液pH变化及临床意义

The change and clinical significance of pH before and after treatment in expired breath condensate of patients with AECOPD

目的探讨慢性阻塞性肺疾病急性加重期(AECOPD)患者治疗前后呼出气冷凝液(EBC)中pH变化的意义及临床价值。方法随机选择AECOPD患者20例,正常健康者20例。比较AECOPD治疗前后EBCpH的变化及与健康对照组EBCpH,探讨AECOPD治疗前EBCPH与肺功能(FEV1、FEV1/FVC、FEV1%预计值)的相关性。结果EBCpH在AECOPD降低,经治疗后升高,但同对照组比较是降低的,有统计学意义(P<0.05)。但AECOPD的EBC中pH与肺功能无明显相关性(P>0.05)。结论AECOPD患者EBC中pH显著降低,气道酸化明显,气道炎症严重,但不能反映肺功能和病情严重情况。因此EBC中pH是监测气道酸碱度和COPD急性发作的有效指标。

Objective To evaluate the change and the clinical practice value of pH in expired breath condensate（EBC） with acute exacerbation chronic obstructive pulmonary disease （AECOPD） before and after treatment, and to assess the relationship between the acidity and airway imflammation and disease severity. Methods 20 AECOPD patients and 20 normal ones were randomly chosen as control groups, compared the changes of EBC pH between the AECOPD groups before and after treatment with control. Moreover, the relationship in AECOPD group between EBC pH and lung function （FEV1 , FEV1/FVC, FEV1% Predicted value） was assessed. Breath condensate samples were collected using as a specially designed con- densing chamber. The pH values were measured in their breath condensate through pH electrode. The datas were analyzed with statistic method. Results Significantly lower EBC pH were found in AECOPD before treatment （ 6.56 ±0.96 ） compared to after treatment （7.23 ±0.74 ） and the control group （ 7.97 ±0.12 ） （ P 〈 0.05）. EBC pH values manifested no correlation between FEV1 ,FEV1/FVC and FEV1% predicted value （ P 〉 0.05 ） in AECOPD patients before treatment. Conclusion We concluded that pH decreased in the EBC of patients with COPD and in AECOPD especially. The measurement of the EBC pH may be useful in screening and monitoring air acidification and air inflammation of patient with AECOPD, and the change of pathogenetic condition in COPD. There was no relationship between EBC pH and FEV1 , FEV1/FVC and FEV1% predicted value, which suggested that change of EBC pH in AECOPD patient could not reflect the change of lung function and severity of disease to some extent.