内源性和外源性气道酸化儿童呼吸气冷凝液中的钙和镁
2011/10/12
摘要
背景与目的：气道pH值的调节具有重要的生理学意义。气道酸化可以导致支气管收缩。本研究旨在比较呼出气冷凝液(EBC)中的钙和镁在哮喘未控制（内源性酸化）患儿与胃食管反流疾病（GERD，外源性酸化）患儿之间是否存在差异。
材料与方法：共142名儿童入选本研究。其中包括51名哮喘未控制患儿、61名GERD患儿以及30名健康对照儿童。此外，根据哮喘患儿和GERD患儿的pH值分为2个亚组：pH ≤ 6.93组（亚组A）和pH > 6.93组（亚组B）。
结果：与GERD患儿相比，哮喘患儿的EBC平均pH值显著降低(6.791 ± 0.374 vs. 7.002 ± 0.361, p =0.006)。哮喘患者[10 (10-40) μmol/L, p =0.016]和GERD患者[20 (10-40) μmol/L, p =0.012]的总镁浓度（中位数和四分位区间较对照组显著降低(47 ± 27 μmol/L)。EBC中钙和镁的含量在哮喘患儿和GERD患儿间无显著差异。哮喘患儿中，用力第一秒呼气体积（FEV1）和EBC中镁含量间存在正相关性(r = 0.307; p =0.030)，且FEV1与钙/镁比值存在负相关(r = -0.290; p =0.047)。此外，呼出气冷凝液中的NO含量与钙/镁比值间存在正相关(r = 0.360; p =0.018)。GERD患儿中，镁含量与pH值间存在负相关。GERD亚组A患儿的钙浓度[50 (30-90) μmol/L]显著高于亚组B患儿[30 (20-45) μmol/L, p =0.031]。此外，GERD患儿亚组A患儿的镁浓度[30 (20-70) μmol/L]显著高于亚组B患儿[10 (10-20) μmol/L, p <0.001]。
结论：本研究结果显示，不管是内源性机制还是胃食管反流导致外源性气道酸化，患儿EBC中总镁浓度都出现了下降。GERD患儿在急性咳嗽后应该检测EBC的pH值。未来有必要对这些现象的发生和发展机制进行研究。
科学意义：EBC中镁浓度的下降提示镁离子可能参与了支气管收缩。
（苏楠 审校）
J Asthma. 2011 Sep;48(7):667-73. Epub 2011 Aug 5.
Calcium and magnesium in exhaled breath condensate of children with endogenous and exogenous airway acidification.
Banović S, Navratil M, Vlašić Z, Topić RZ, Dodig S.
Source
Department for Clinical Laboratory Diagnosis, Srebrnjak Children’s Hospital , Zagreb , Croatia.
Abstract
BACKGROUND AND AIMS: Regulation of pH in the airways is of physiological importance. As acidification of the airways causes bronchoconstriction, the aim of the present study was to find out whether there is any difference in calcium and magnesium in exhaled breath condensate (EBC) of children with uncontrolled asthma (i.e., with endogenous acidification) and children with gastroesophageal reflux disease, GERD (i.e., with exogenous acidification).
MATERIAL AND METHODS: A total of 142 children were included in the study: children with uncontrolled asthma (N = 51), children with GERD (N = 61), and healthy controls (N = 30). In addition, according to the pH cut-off value children with asthma and GERD were divided into two subgroups, that is, patients with pH ≤ 6.93 (subgroup A) and patients with pH > 6.93 (subgroup B).
RESULTS: The mean EBC pH was significantly lower in children with asthma than in children with GERD (6.791 ± 0.374 vs. 7.002 ± 0.361, p = .006). Concentration [median and interquartile range-M (IQR)] of total magnesium, but not calcium, was lower in both asthmatic [(10 (10-40) μmol/L, p = .016)] and GERD children [(20 (10-40) μmol/L, p = .012)] in comparison with controls (47 ± 27 μmol/L). There was no statistically significant difference in EBC calcium and magnesium concentrations between asthmatic and GERD children. In asthmatic children a positive correlation was confirmed between forced expiratory volume in the first second (FEV1) and magnesium in EBC (r = 0.307; p = .030), and negative correlation was found between FEV1 and calcium/magnesium ratio (r = -0.290; p = .047). In addition, positive correlation was confirmed between fractional concentration of exhaled NO and calcium/magnesium ratio (r = 0.360; p = .018). In GERD patients a negative correlation (r = -0.404; p = .003) was found between magnesium and pH values. Concentration of calcium was higher in the GERD subgroup A children [(50 (30-90) μmol/L)] than in the subgroup B children [(30 (20-45) μmol/L, p = .031)]. In addition, concentration of magnesium was higher in the GERD subgroup A children [(30 (20-70) μmol/L)] than in the subgroup B children [(10 (10-20) μmol/L, p < .001)].
CONCLUSION: The present study indicates that decreased total magnesium concentration may be found in EBCs, irrespective of whether the acidification is the result of endogenous pathomechanisms or reflux-induced mechanisms. In children with GERD, EBC pH-metry should be performed after acute coughing episode. Future research is needed to investigate the mechanisms of onset and dynamics of these changes.
SCIENTIFIC SIGNIFICANCE: Lower concentration of magnesium may indicate its role in bronchoconstiction.
J Asthma. 2011 Sep;48(7):667-73. Epub 2011 Aug 5.
背景与目的：气道pH值的调节具有重要的生理学意义。气道酸化可以导致支气管收缩。本研究旨在比较呼出气冷凝液(EBC)中的钙和镁在哮喘未控制（内源性酸化）患儿与胃食管反流疾病（GERD，外源性酸化）患儿之间是否存在差异。
材料与方法：共142名儿童入选本研究。其中包括51名哮喘未控制患儿、61名GERD患儿以及30名健康对照儿童。此外，根据哮喘患儿和GERD患儿的pH值分为2个亚组：pH ≤ 6.93组（亚组A）和pH > 6.93组（亚组B）。
结果：与GERD患儿相比，哮喘患儿的EBC平均pH值显著降低(6.791 ± 0.374 vs. 7.002 ± 0.361, p =0.006)。哮喘患者[10 (10-40) μmol/L, p =0.016]和GERD患者[20 (10-40) μmol/L, p =0.012]的总镁浓度（中位数和四分位区间较对照组显著降低(47 ± 27 μmol/L)。EBC中钙和镁的含量在哮喘患儿和GERD患儿间无显著差异。哮喘患儿中，用力第一秒呼气体积（FEV1）和EBC中镁含量间存在正相关性(r = 0.307; p =0.030)，且FEV1与钙/镁比值存在负相关(r = -0.290; p =0.047)。此外，呼出气冷凝液中的NO含量与钙/镁比值间存在正相关(r = 0.360; p =0.018)。GERD患儿中，镁含量与pH值间存在负相关。GERD亚组A患儿的钙浓度[50 (30-90) μmol/L]显著高于亚组B患儿[30 (20-45) μmol/L, p =0.031]。此外，GERD患儿亚组A患儿的镁浓度[30 (20-70) μmol/L]显著高于亚组B患儿[10 (10-20) μmol/L, p <0.001]。
结论：本研究结果显示，不管是内源性机制还是胃食管反流导致外源性气道酸化，患儿EBC中总镁浓度都出现了下降。GERD患儿在急性咳嗽后应该检测EBC的pH值。未来有必要对这些现象的发生和发展机制进行研究。
科学意义：EBC中镁浓度的下降提示镁离子可能参与了支气管收缩。
（苏楠 审校）
J Asthma. 2011 Sep;48(7):667-73. Epub 2011 Aug 5.
Calcium and magnesium in exhaled breath condensate of children with endogenous and exogenous airway acidification.
Banović S, Navratil M, Vlašić Z, Topić RZ, Dodig S.
Source
Department for Clinical Laboratory Diagnosis, Srebrnjak Children’s Hospital , Zagreb , Croatia.
Abstract
BACKGROUND AND AIMS: Regulation of pH in the airways is of physiological importance. As acidification of the airways causes bronchoconstriction, the aim of the present study was to find out whether there is any difference in calcium and magnesium in exhaled breath condensate (EBC) of children with uncontrolled asthma (i.e., with endogenous acidification) and children with gastroesophageal reflux disease, GERD (i.e., with exogenous acidification).
MATERIAL AND METHODS: A total of 142 children were included in the study: children with uncontrolled asthma (N = 51), children with GERD (N = 61), and healthy controls (N = 30). In addition, according to the pH cut-off value children with asthma and GERD were divided into two subgroups, that is, patients with pH ≤ 6.93 (subgroup A) and patients with pH > 6.93 (subgroup B).
RESULTS: The mean EBC pH was significantly lower in children with asthma than in children with GERD (6.791 ± 0.374 vs. 7.002 ± 0.361, p = .006). Concentration [median and interquartile range-M (IQR)] of total magnesium, but not calcium, was lower in both asthmatic [(10 (10-40) μmol/L, p = .016)] and GERD children [(20 (10-40) μmol/L, p = .012)] in comparison with controls (47 ± 27 μmol/L). There was no statistically significant difference in EBC calcium and magnesium concentrations between asthmatic and GERD children. In asthmatic children a positive correlation was confirmed between forced expiratory volume in the first second (FEV1) and magnesium in EBC (r = 0.307; p = .030), and negative correlation was found between FEV1 and calcium/magnesium ratio (r = -0.290; p = .047). In addition, positive correlation was confirmed between fractional concentration of exhaled NO and calcium/magnesium ratio (r = 0.360; p = .018). In GERD patients a negative correlation (r = -0.404; p = .003) was found between magnesium and pH values. Concentration of calcium was higher in the GERD subgroup A children [(50 (30-90) μmol/L)] than in the subgroup B children [(30 (20-45) μmol/L, p = .031)]. In addition, concentration of magnesium was higher in the GERD subgroup A children [(30 (20-70) μmol/L)] than in the subgroup B children [(10 (10-20) μmol/L, p < .001)].
CONCLUSION: The present study indicates that decreased total magnesium concentration may be found in EBCs, irrespective of whether the acidification is the result of endogenous pathomechanisms or reflux-induced mechanisms. In children with GERD, EBC pH-metry should be performed after acute coughing episode. Future research is needed to investigate the mechanisms of onset and dynamics of these changes.
SCIENTIFIC SIGNIFICANCE: Lower concentration of magnesium may indicate its role in bronchoconstiction.
J Asthma. 2011 Sep;48(7):667-73. Epub 2011 Aug 5.
上一篇：
哮喘、过敏症和呼吸道感染：维生素D理论
下一篇：
小鼠IgG免疫复合体通过活化NFκB诱导炎症细胞向气道募集和TNF介导的迟发性气道高反应性
