病毒感染对门诊中哮喘急性发作的影响：一项前瞻性研究
2016/05/31
摘要
背景:病毒感染引发哮喘急性加重的患病率及其对症状和病程的影响尚不清楚。
方法:2012年2月到2013年2月广州医科大学附属第一医院收治哮喘患者, 以健康人群作为对照。采集鼻拭子，并对呼吸道病毒做PCR检测。所有患者完成问卷调查和肺功能测试。部分患者随访4周，通过记哮喘日记对症状的改变进行评价。
结果：本研究总共收治了70例哮喘急性发作患者，其中，34例患者（48.6%）完成了为期4周的随访研究。本研究还包括另外65名稳定的哮喘患者和134名健康志愿者。通过PCR检测病毒在哮喘急性发作期患者的阳性率为34.2%（24/70），显著高于稳定哮喘对照组（12/65；18.5%；P=0.038）和正常人群对照组（18/134；13.4%；P< 0.001）。病毒阳性患者中，哮喘急性加重患者【（5±×4.63）10（7）copies/L】（平均值±SD）的病毒拷贝数明显高于哮喘稳定期的患者【（1.24±×1.44）10（6）copies/L；P<0.001】或健康对照组【（1.44±×0.44）10（6）copies/L；P<0.001】，个体之间病毒载量并没有显著不同（P = 0.774）。4周随访期间，第1天和第3天咳嗽评分在病毒阳性组明显高于病毒阴性组（第1天：P = 0.016；第3天：P = 0.004）。然而，测试的其它症状在这两组间无显著差异，比如呼吸困难和总恢复时间（P>0.05）。
结论：呼吸道病毒可能参与哮喘急性加重，诱导更为突出和持续的咳嗽症状。
（杨冬 审校）
J Thorac Dis. 2016 Mar;8(3):505-12. doi: 10.21037/jtd.2016.02.76.
Impact of viral infection on acute exacerbation of asthma in out-patient clinics: a prospective study.
Liao H1, Yang Z1, Yang C1, Tang Y1, Liu S1, Guan W1, Chen R1.
Author information
Abstract
BACKGROUND:The prevalence of viral infection triggering asthma exacerbation and its impact on the symptoms and duration of exacerbation are unclear.
METHODS:Asthma and healthy control subjects were recruited from the First Affiliated Hospital of Guangzhou Medical University between February 2012 and February 2013. Nasal swabs were collected, and respiratory viruses were detected by polymerase chain reaction (PCR). All patients completed questionnaires and a lung function test. Some were followed up for 4 weeks, and symptom changes were evaluated via asthma diaries.
RESULTS:In total, 70 patients with acute asthma exacerbations were recruited. Among them, 34 patients (48.6%) completed the 4-week follow-up study. Another 65 patients with stable asthma and 134 healthy volunteers were also included in this study. The rate of positive viral detection via PCR in acute asthma exacerbation patients was 34.2% (24/70), which is significantly higher than that of stable asthma (12/65; 18.5%; P=0.038) and normal control patients (18/134; 13.4%; P<0.001). Among the viral-positive subjects, the number of viral copies was significantly higher in acuteasthma exacerbation patients [(5.00±4.63) ×10(7) copies/L] (mean ± SD) than those in stable asthma patients [(1.24±1.44) ×10(6) copies/L; P<0.001] or in healthy controls [(1.44±0.44) ×10(6) copies/L; P<0.001], whose viral loads were not significantly different from one another (P=0.774). During the 4-week follow-up period, the cough scores on days 1 and 3 were significantly higher in the viral-positive group than in the viral-negative group (day 1: P=0.016; day 3: P=0.004). However, there were no significant differences between these two groups for other tested symptoms, such as dyspnea and total recovery time (P>0.05).
CONCLUSIONS:Respiratory viruses may be involved in acute asthma exacerbations, inducing more prominent and persistent cough symptoms.
J Thorac Dis. 2016 Mar;8(3):505-12. doi: 10.21037/jtd.2016.02.76.
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中华人民共和国全国医疗保险系统报道的慢性阻塞性肺疾病诊断的有效性
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城市儿童遭受着哮喘与超重/肥胖的双重困扰
