哮喘联盟

   摘要
   目的：为明确诱导痰中亚硝酸盐(一氧化氮代谢产物)减少和治疗后临床哮喘症状改善之间的关系，我们在秘鲁阿雷基帕一个三级保健医院进行了一项前瞻性、纵向研究。
   方法：在95例轻、中度持续性学龄期哮喘患儿中，进行了诱导痰液样本中的亚硝酸盐检测(采用格里斯试验测试)。在丙酸倍氯米松治疗基线时和治疗3个月后进行了两次临床参数和运动支气管激发(EBC)试验的测试 (平均剂量:300 mcg /天,四分位距[IQR]：300 - 450)。
   结果：95例儿童中有60例完成了该项研究(中位年龄为9岁[IQR：7 - 13])。我们发现纳入时和研究末痰亚硝酸盐水平明显改变（分别为34.4 nmol /ml(IQR:18.2 - 58.4)和11.2 nmol/ml(6 - 20.1], P≤ 0.0001)。同时也发现痰亚硝酸盐水平的减少和临床参数的改善有显著的相关性(急性发作 [r = 0.361, P = 0.005]，沙丁胺醇的使用[r = 0.322, P = 0.013]，急诊患者[r = 0.275, P = 0.033]和学校缺课者[r = 0.41, P = 0.001])。然而，痰亚硝酸盐水平与外周血嗜酸性粒细胞或血清Ig水平或任何时候EBC测试值没有相关性。在每个哮喘组中（轻度和中度），治疗后痰亚硝酸盐水平下降显著，但组与组之间并非如此。
   结论：本研究表明，诱导痰(一个简单且便宜的非侵入性方法)中测定的亚硝酸盐对于监测学龄儿童哮喘治疗是一个良好的选择。
 

（刘国梁 审校）
Pediatr Pulmonol. 2013 Jul 10. doi: 10.1002/ppul.22843. [Epub ahead of print]

 

Correlation between nitrites in induced sputum and asthma symptoms in asthmatic schoolchildren.
 

Castro-Rodriguez JA, Molina RO, Cáceres M, Recabarren A.
 

Abstract
OBJECTIVE: To determine if nitrites (nitric oxide metabolites) measured in induced sputum decrease and correlate with improvement of clinical asthma symptoms after treatment, we performed a prospective longitudinal study in a tertiary care hospital in Arequipa, Peru.
METHODS: In 95 schoolchildren with mild and moderate persistent asthma we determined nitrites in induced sputum samples (measured using the Griess assay). Clinical parameters and exercise bronchial challenge (EBC) test were performed twice, at baseline and after 3 months of beclomethasone-dipropionate treatment (median doses: 300 mcg/day, IQR: 300-450).
RESULTS: Sixty out of 95 children completed the study (median age of 9-year [IQR: 7-13]). A significant change in sputum nitrites levels between admission and the end of the study was observed (34.4 nmol/ml [IQR:18.2-58.4] and 11.2 nmol/ml [6-20.1], respectively, P = < 0.0001). Also a significant correlation between decrease of sputum nitrites levels and improvement of clinical parameters (acute exacerbations [r = 0.361, P = 0.005]; use of salbutamol [r = 0.322, P = 0.013]; emergency visits [r = 0.275, P = 0.033]; and school absence [r = 0.41, P = 0.001]) from admission to the end of the study was found. However, sputum nitrites levels did not correlated with peripherical blood eosinophils or serum IgE levels or with EBC test at any point of the study. The decrease of sputum nitrites levels after the treatment was significant in each asthma group (mild and moderate), but not between groups.
CONCLUSION: This study showed that measured nitrite in induced sputum (a simple and cheap non-invasive method) is a good alternative for monitoring asthmatic treatment in schoolchildren.
 

Pediatr Pulmonol. 2013 Jul 10. doi: 10.1002/ppul.22843. [Epub ahead of print]