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【文摘发布】应用诱导痰研究哮喘的气道酸化
Author:Metka Kodric
Abstract:
Rationale: Acidification of the airways seems to be involved in asthma pathophysiology, but its assessment might be difficult.
Objectives: The aim of our study is to assess the feasibility and validity of airway acidification measurement by induced sputum and its clinical significance in asthma.
Methods: Induced-sputum samples were obtained in 57 outpatients with asthma. The between-sample repeatability after 48 hours was measured in an independent population of 14 patients with asthma. pH was measured using a pH meter. The control of asthma was established by the Asthma Control Questionnaire.
Measurements and Main Results: The pH measurement was feasible in all samples and repeatable both within (intraclass correlation coefficient [ICC], 0.96) and between samples (ICC, 0.621). The mean pH was significantly different between healthy subjects and patients with asthma, including in those with controlled (mean pH: 7.54 in healthy subjects vs. 7.28 in subjects with controlled asthma; p = 0.0105) and uncontrolled disease (mean pH: 7.54 in healthy subjects vs. 7.06 in subjects with uncontrolled disease; p < 0.0001), and between patients with stable asthma and those with poorly controlled asthma (7.28 vs. 7.06, respectively; p = 0.0134). The validity of the method was assessed with the receiver operating characteristic curves and induced-sputum lower pH values (with a cutoff value of 7.3; sensitivity, 72.1%; specificity, 100%).
Conclusions: Patients with asthma show lower pH than healthy subjects. Patients with poorly controlled asthma seem to have the lowest induced-sputum pH, independent of the GINA (Global Initiative for Asthma) severity level. In conclusion, induced sputum is a feasible, repeatable, noninvasive method to measure airway pH. The pH in induced sputum may reflect a different aspect of asthma from sputum eosinophils and be related to different pathophysiologic factors.
Key Words: asthma • airway acidification • induced sputum
AT A GLANCE COMMENTARY
Scientific Knowledge on the Subject
The acidification of the airways seems to be involved in asthma pathophysiology. To date, airway pH was assessed mostly by invasive methods or by exhaled breath condensate.
What This Study Adds to the Field
Airway acidification can also be measured by induced sputum and may be clinically relevant.
American Journal of Respiratory and Critical Care Medicine Vol 175. pp. 905-910, (2007)
认领及参与讨论者方可pm我要全文 Title:An Investigation of Airway Acidification in Asthma Using Induced Sputum
标题：利用诱导痰方法进行哮喘患者气道酸化的研究
Author:Metka Kodric
作者：Metka Kodric`
Abstract:
摘要：
Rationale: Acidification of the airways seems to be involved in asthma pathophysiology, but its assessment might be difficult.
背景：气道酸化似乎涉及到哮喘的病理生理改变，但是评估可能很困难。
Objectives: The aim of our study is to assess the feasibility and validity of airway acidification measurement by induced sputum and its clinical significance in asthma.
目的：我们研究的目的是评估利用诱导痰法测定气道酸化的可行性和可靠性，以及它的临床意义。
Methods: Induced-sputum samples were obtained in 57 outpatients with asthma.
The between-sample repeatability after 48 hours was measured in an independent
population of 14 patients with asthma. pH was measured using a pH meter. The
control of asthma was established by the Asthma Control Questionnaire.
方法：从57位院外哮喘患者中获得诱导痰标本。pH计测定pH值。在独立的14位哮喘患者中48小时后重复测量pH值。通过哮喘控制问卷来确定病情控制情况。
Measurements and Main Results: The pH measurement was feasible in all samples
and repeatable both within (intraclass correlation coefficient [ICC], 0.96) and
between samples (ICC, 0.621). The mean pH was significantly different between
healthy subjects and patients with asthma, including in those with controlled
(mean pH: 7.54 in healthy subjects vs. 7.28 in subjects with controlled asthma;
p = 0.0105) and uncontrolled disease (mean pH: 7.54 in healthy subjects vs.
7.06 in subjects with uncontrolled disease; p < 0.0001), and between patients
with stable asthma and those with poorly controlled asthma (7.28 vs. 7.06,
respectively; p = 0.0134). The validity of the method was assessed with the
receiver operating characteristic curves and induced-sputum lower pH values
(with a cutoff value of 7.3; sensitivity, 72.1%; specificity, 100%).
测量方法和主要结果：所有样本的pH值测定是可靠的，组内（同类相关系数，0.96）和组间(同类相关系数,0.621)都可重复的。正常组和哮喘组pH均值具有显著性差异，包括症状控制（健康者平均pH值：7.54，哮喘控制组平均pH值：7.28 ; p = 0.0105）和未控制组（健康者平均pH值：7.54，哮喘控制组平均pH值：7.06 ; p < 0.0001），稳定期患者与控制差的患者之间（分别为7.28 vs. 7.06,p = 0.0134）。方法的可靠性通过ROC曲线和诱导痰低pH值来评价（截断值7.3;敏感性, 72.1%; 特异性, 100%）。
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作者:admin@医学,生命科学 2011-07-09 12:01
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