哮喘、COPD急性加重时呼出气冷凝液中PH测定
2010/12/07
呼出气冷凝液（EBC）PH测定是气道炎症的无创标记物，由于其测定技术难以标准化，不同研究中所得出的数值也用所不同。本文作者应用非常精确的二氧化碳标准化法测定哮喘及慢性阻塞性肺病（COPD）患者急性加重时EBC的PH值，该方法排除了CO2对EBC酸度的影响。选取20名非吸烟哮喘患者，21名尚在吸烟者及17名已戒烟的COPD患者，这些患者均因急性加重入院，在住院第1天及治疗后出院时测定EBC的PH值，呼出气NO，肺功能及血气分析，同时还测定了18名吸烟健康对照者及18名非吸烟健康对照者EBC的PH值。哮喘患者急性加重时EBC的PH值较非吸烟对照者显著下降，治疗后持续上升，而正吸烟或已戒烟的COPD患者急性加重时EBC的PH值均无显著变化。吸烟的COPD患者EBC的PH值低于非吸烟COPD患者，健康吸烟者与非吸烟者也有同样差异。EBC的PH值与呼出气NO、肺功能无显著相关。
该研究表明哮喘急性加重时呼出气冷凝液酸度提高，而COPD急性加重时则无显著变化。
该研究表明哮喘急性加重时呼出气冷凝液酸度提高，而COPD急性加重时则无显著变化。
（马艳良 北京大学人民医院呼吸科 100044 摘译）
（Am J Respir Crit Care Med. 2010 Jul 23）
Am J Respir Crit Care Med. 2010 Jul 23. [Epub ahead of print]
Assessment of Exhaled Breath Condensate pH in Exacerbations of Asthma and COPD: ALongitudinal Study.
Antus B, Barta I, Kullmann T, Lazar Z, Valyon M, Horvath I, Csiszer E.
RATIONALE: Exhaled breath condensate pH has been proposed as a non-invasive
marker of airway inflammation. However, due to standardization difficulties in pH
measurement techniques different pH readings were obtained in previous studies.
OBJECTIVES: In this longitudinal study we assessed condensate pH in patients with
an exacerbation of asthma or chronic obstructive airway disease using the very
precise carbon-dioxide standardization method which negates the effect of this
gas on condensate acidity.
METHODS: Condensate pH, fractional exhaled nitricoxide, lung function and blood gases were measured in 20 non-smoking asthmatics, 21 smoking and 17 ex-smoking patients with chronic obstructive airway diseasefirst at hospital admission due to an acute exacerbation of the disease, andagain at discharge following treatment. Condensate pH was also assessed in 18smoking and 18 non-smoking healthy controls.
METHODS: Condensate pH, fractional exhaled nitricoxide, lung function and blood gases were measured in 20 non-smoking asthmatics, 21 smoking and 17 ex-smoking patients with chronic obstructive airway diseasefirst at hospital admission due to an acute exacerbation of the disease, andagain at discharge following treatment. Condensate pH was also assessed in 18smoking and 18 non-smoking healthy controls.
MEASUREMENTS AND MAIN RESULTS: Inasthmatics condensate pH was significantly decreased at the time of exacerbation compared to non-smoking controls and increased along with treatment. In patients with chronic obstructive airway disease, condensate pH remained unchanged during exacerbation, both in smokers and ex-smokers. Nevertheless, condensates collectedfrom smokers were more acidic than those of ex-smokers. A similar difference was observed between smoker and non-smoker healthy controls. No correlations werefound between condensate pH and fractional exhaled nitric oxide or lung function variables measured either at admission or discharge.
CONCLUSIONS: Our datasuggest that exacerbation of asthma but not chronic obstructive airway disease isassociated with acidification of breath condensate.
CONCLUSIONS: Our datasuggest that exacerbation of asthma but not chronic obstructive airway disease isassociated with acidification of breath condensate.
PMID: 20656939 [PubMed - as supplied by publisher]
