哮喘患儿及青少年的运动性支气管痉挛和呼气冷凝液中8-异前列烷的测定
2009/05/18
哮喘患儿中运动性支气管痉挛（EIB）与持续的气道炎症和病情控制不佳有关。EIB可部分来源于气道的氧化应激，如果监测8-异前列烷(IsoP)（已知的一种氧化应激反应的标志物）在呼气冷凝液（EBC）中的值，可能有助于非侵袭性地监测哮喘。就此，MarioBarreto等人选取了46名哮喘患儿和6～17岁的青少年（29名男性），所有人均进行了肺功能测定，测量了呼气一氧化氮(FENO)的浓度变化，并在运动激发试验前后测量了呼气冷凝液（EBCs）中8-异前列烷(IsoP)的水平。分别在运动激发试验前和激发后5分钟、激发后10分钟时测定呼出NO值，分别在运动后1、5、10、15、20分钟时进行肺功能检测。
结果发现在运动后5分钟时，FEV1下降程度与基础8-IsoP水平相关(r = 0.47; p = 0.002)，与基础FENO水平不相关。运动激发前后8-IsoP水平无明显变化。相反，在运动激发试验后5分钟时，下降的FENO值与FEV1下降程度相关。12例EIB患者中基础8-IsoP平均浓度比没有EIB的34例患者的值高（44.9 pg/mL [95% (CI), 38.3 to 51.5]，vs 32.3 pg/mL [95% CI, 27.6 to 37.0],; p < 0.01）。有EIB和没有EIB两组患者的基础FENO值无明显差异(EIB组: 38.7 ppb; 95% CI, 24.5 to 61.1; 非EIB组: 29.1 ppb; 95% CI, 22.0 to 38.4)。
该研究得出：伴有EIB的哮喘患儿和青少年的EBC标本可见8-IsoP值的升高，表明其在支气管气道高反应的氧化应激中起一定作用。
（于娜 中国医科大学附属第一医院呼吸科 110001 摘译）
（Chest January 2009 135:66-73; doi:10.1378/chest.08-0722）
（Chest January 2009 135:66-73; doi:10.1378/chest.08-0722）
8-Isoprostane in Exhaled Breath Condensate and Exercise-Induced Bronchoconstriction in Asthmatic Children and Adolescents
1.Mario Barreto, MD*,
2.Maria Pia Villa, MD,
3.Carla Olita, MD,
4.Susy Martella, L Tech,
5.Giovanni Ciabattoni, MD and
6.Paolo Montuschi, MD
Abstract
Background:Exercise-induced bronchoconstriction (EIB) in the asthmatic child is associated with persistent airway inflammation and poor disease control. EIB could arise partly from airway oxidative stress. Exhaled breath condensate (EBC) levels of 8-isoprostane (IsoP), which is a known marker of oxidative stress, might therefore be helpful for monitoring asthma noninvasively.
Methods:We recruited 46 asthmatic children and adolescents 6 to 17 years of age (29 boys), all of whom underwent lung function testing, measurement of the fractional concentration of exhaled nitric oxide (FENO), and collection of EBCs for 8-IsoP measurement before and after exercise challenge. FENO was measured before exercise and 5 min and 20 min after exercise. Spirometry was repeated 1, 5, 10, 15, and 20 min after exercise.
Results:Baseline 8-IsoP levels (but not baseline FENO levels) correlated with the fall in FEV1 5 min after exercise (r = − 0.47; p = 0.002). 8-IsoP levels measured after exercise remained unchanged from baseline levels; conversely, FENO levels decreased in parallel with the decline in FEV1 at 5 min (r = 0.44; p = 0.002). The mean baseline 8-IsoP concentrations were higher in patients with EIB (n = 12) than in those without EIB (n = 34; 44.9 pg/mL [95% confidence interval (CI), 38.3 to 51.5] vs 32.3 pg/mL [95% CI, 27.6 to 37.0], respectively; p < 0.01). No difference was found in the mean baseline FENO between groups (with EIB group: 38.7 ppb; 95% CI, 24.5 to 61.1; without EIB group: 29.1 ppb; 95% CI, 22.0 to 38.4).
Conclusions:Increased 8-IsoP concentrations in EBC samples of asthmatic children and adolescents with EIB suggest a role for oxidative stress in bronchial hyperreactivity.
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职业性哮喘的一项新的诊断评分标准——日间工作状态与非工作时最大呼气流量的曲线间面积（ABC评分）
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定量CT检测气流闭陷的哮喘表型的危险因素—一项多因素分析
