哮喘联盟

   摘要
   哮喘发作儿童存在气道酸化现象呼气冷凝液（EBC）被越来越常用作气道粘膜液的样本。哮喘病人呼气冷凝液的PH值低于正常人，并与气道炎症相关。本研究旨在评估哮喘儿童急性发作期呼气冷凝液PH值，及其与治疗之间的关系，研究设计了对照组呼气冷凝液。本研究共纳入了12例哮喘发作儿童和27例健康儿童。比较哮喘儿童与健康儿童的临床表现及哮喘标准治疗前后呼气冷凝液的PH值（哮喘标准治疗：根据国际哮喘指南，对哮喘儿童给予吸入性β2受体激动剂及皮质类固醇激素治疗）。所有儿童采用皮肤点刺试验进行气道过敏原检测。对哮喘儿童进行呼吸量检测。相比对照组（均值±标准差＝8.12 ± 0.19），哮喘发作儿童治疗前呼气冷凝液PH值显著降低（7.87 ± 0.66；p = 0.03），但治疗后呼气冷凝液PH值无明显差异（8.11 ± 0.06; p = 0.40）。组间分析显示，哮喘儿童治疗前呼气冷凝液PH值稍低于治疗后，但无显著性差异。呼气冷凝液PH值与系统性糖皮质激素治疗或肺功能均无相关性。75%哮喘儿童属于过敏性哮喘。哮喘发作儿童治疗前EBC PH值降低。我们需要样本量更大的临床试验去验证EBC PH值是否可以作为有效指导儿童哮喘发作治疗的非侵入性生物指标。
 

（苏楠 审校）
Allergy Asthma Proc. 2014 May;35(3):51-6. doi: 10.2500/aap.2014.35.3740.

 

Airway acidification in childhood asthma exacerbations.
 

Caffarelli C1, Dascola CP, Peroni D, Ricò S, Stringari G, Varini M, Folesani G, Corradi M.
 

Abstract
Exhaled breath condensate (EBC) is being used increasingly to sample airway lining fluid. In asthmatic patients, the concentration of pH in EBC has been found to be decreased and to be related to airway inflammation. The aim of this study was to determine exhaled pH levels during acute asthma exacerbations in relation to pharmacologic treatment in asthmatic children and compare these with control subjects. Twelve asthmatic children with asthma exacerbation and 27 healthy children were enrolled. Clinical observations and pH in EBC before and after standard treatment for asthma attack, based administration of inhaled beta2-agonist, and corticosteroid, according to international Global Initiative for Asthma guidelines, were compared with those in healthy subjects. All children performed skin-prick tests to aeroallergens. Asthmatic children underwent spirometry. Exhaled pH levels were significantly lower in children with asthma exacerbation before treatment (mean ± SD = 7.87 ± 0.66; p = 0.03) but not after treatment (8.11 ± 0.06; p = 0.40) compared with controls (8.12 + 0.19). Intragroup analyses found that condensate pH levels in asthmatic children before treatment were lower, but not significantly, than those after treatment. No correlation was found between pH values and treatment with systemic corticosteroids or lung function. Asthmatic children were atopic in 75% of cases. Levels of pH are decreased in EBC of asthmatic children with exacerbation before treatment. Larger studies are required to determine whether EBC pH levels may be a useful noninvasive biomarker to guide treatment of asthma exacerbations in childhood.
 

Allergy Asthma Proc. 2014 May;35(3):51-6. doi: 10.2500/aap.2014.35.3740.