支气管哮喘患者呼出气冷凝液pH值变化的临床意义

Clinical significance of changes of exhaled breath condensate pH value in bronchial asthma patients

目的:探讨哮喘气道炎症时pH值变化以及监测pH值与气道炎症和临床过程间的意义。方法:选择哮喘患者和健康对照组各30例,哮喘患者诊断及病情分期、分级参照2003年中华医学会呼吸病学分会哮喘学组推荐标准。结果:呼出气冷凝液(EBC)的pH值:哮喘急性发作期,非急性发作期;健康对照组比较差异有统计学意义(均P<0.01);哮喘急性发作期、非急性发作期均较健康对照组低(均P<0.01);哮喘急性发作期较非急性发作期低(P<0.01);非急性发作期中轻度持续期及中重度持续期均较健康对照组低(均P<0.01);轻度间歇期与健康对照组比较,差异无统计学意义(P>0.05);轻度间歇期、轻度持续期及中、重度持续期比较差异有统计学意义(P=0.000);中、重度哮喘较轻度持续期低,轻度持续较轻度间歇期低(均P<0.01);轻度持续哮喘患者激素治疗1个月)、治疗3个月与治疗前比较,差异有统计学意义(P=0.000)。治疗1个月与治疗前比较,差异无统计学意义(P=0.105),且仍较健康对照组低(P<0.05),而治疗3个月高于治疗前和治疗1个月,差异均有统计学意义(均P<0.05),与健康对照组差异无统计学意义(P>0.05);哮喘患者EBC的pH值与FEⅤl无明显相关性(均P>0.05)。结论:EBC中pH值的检测有助于了解气道炎症状态,其方法简便、无创安全,可望成为监测哮喘气道炎症的客观指标。

To investigate the changes of exhaled breath condensate（EBC） pH value in asthmatic airway inflammation and the significance between monitoring EBC pH with airway inflammation and clinical course.Methods ： 30 cases of asthma and the other 30 healthy subjects were selected. Diagnosis, stage and classification of asthma were referred to the criteria recommended by the Asthma Group of the Respiratory Branch of the Chinese Medical Association in 2003. T test,variance analysis and Q test were used in the comparison between the two groups, multigroup comparison and intergroup comparison. The correlation analysis was performed by linear regression method.Results：The EBC pH values showed the statistical difference among the groups of acute exacerbation and non-acute exacerbation of asthma and the healthy control group （P〈0.01）.The EBC pH values in the acute exacerbation group was lower than that in the non-acute exacerbation group （P〈0.01）. In the non-acute exacerbation groups ,the EBC pH values in the mild persistent group and moderate and severe persistent group was lower than that in the healthy control group （P〈0.01）.There was no statistical significance between the mild intermittence group and the healthy group （P〉0.05）,while the difference among the mild intermittence, mild persistent and moderate and severe asthma groups showed the statistical significance （P=0.000）.The moderate and severe asthma group＇s was lower than the mild asthma group＇s and mild persistent group＇s was lower than mild intermittence group＇s（P〈0.01）.Comparing l-month and 3-month hormonotherapy with before treatment in the mild asthma group showed no statistical difference （P=0.105）, but still lower than the healthy control＇s. （P〈0.05）.The EBC pH values in 3-month treatment group was higher than that in 1-month treatment and before treatment with statistical difference （P〈0.05）, but there was no statistical difference compared with the healthy control （P=0.499）.The EBC pH value had no obvious relativity with FEV1 （P〉0.05）.Conclusion：Detecting the EBC pH value is helpful to understand the status of airway inflammation, which is simple, convenient,noninvasive and safe.EBC pH could be expected to become the objective index for monitoring asthmatic airway inflammation.