摘要
目的:对比分析胸闷变异性哮喘(chest tightness variant asthma,CTVA)与典型哮喘(classic asthma,CA)患者的肺功能及嗜酸性粒细胞炎症指标,进一步加深对CTVA的认识。方法:回顾性分析2019年10月—2021年10月门诊诊治的55例CTVA患者与94例CA患者(两组患者气道激发试验均为阳性,符合哮喘诊断标准的病史及临床特征),分析比较两组人群之间的肺功能检查、呼出气体一氧化氮(fractional exhaled nitric oxide,FeNO)、血嗜酸性粒细胞,特异性IgE及总IgE水平。结果:CTVA组与CA组患者年龄、性别比例、过敏史、过敏性鼻炎史、鼻息肉史、湿疹史、慢性荨麻疹史均无统计学差异(P>0.05)。CTVA组的小气道功能轻度受损情况低于CA组(27.27%vs.43.63%,P=0.047)。两组小气道功能中-重度损、气道阻力升高、残总比无统计学差异(P>0.05)。两组通气功能[用力肺活量(forced vital capacity,FVC)、第1秒用力呼气容积占用力肺活量的比值(forced expiratory volume in one second/forced vital capacity,FEV1/FVC)、呼气峰值流量(peak expiratory flow,PEF)]、肺储备功能[最大通气量(maximal voluntary ventilation,MVV)]无明显差异(P>0.05)。CTVA组外周血嗜酸性粒细胞[绝对值(0.16±0.15)×109个/L,百分比(2.50±2.25)%]均显著低于CA组[绝对值(0.27±0.25)×109个/L,百分比(4.0±3.8)%],差异有统计学意义[P=0.017(绝对值),P=0.031(百分比)]。CTVA组的特性IgE检测阳性率(23.8%)低于CA组(48.5%)(P=0.043),且CTVA组外周血总IgE水平[86.7(24.7,172.9)kU/L)]显著低于CA组[181.2(97.3,454.8)k U/L],差异有统计学意义(P=0.009)。CTVA组FeNO平均浓度(29 ppb)较其CA组(79 ppb)显著降低,差异有统计学意义(P=0.027)。结论:CTVA患者小气道轻度阻塞率较CA患者少,小气道中重度阻塞率和CA患者相当,外周血嗜酸性细胞水平较CA患者低。
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 94patients 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
作者
张明强
郭文佳
徐文帅
赵丽娜
孙姝妍
牟向东
ZHANG Mingqiang;GUO Wenjia;XU Wenshuai;ZHAO Lina;SHUN Shuyan;MOU Xiangdong(Department of Respiratory and Critical Care Medicine,Beijing Tsinghua Changgung Hospital,School of Clinical Medicine,Tsinghua University,Beijing 102218,China)
出处
《南京医科大学学报（自然科学版）》
CAS
北大核心
2023年第2期225-229,262,共6页
Journal of Nanjing Medical University(Natural Sciences)
基金
国家自然科学基金(81900021)。
