哮喘患者呼吸道热量和湿气流失与嗜酸性粒细胞炎症有关
2007/04/13
粘膜血管增多是哮喘气道炎症的重要标志之一，如果这种变化能够引起可以测定的呼吸道热量和湿度的丢失（respiratory heat and moisture loss，RHML)，那么后者将能反映气道炎症的程度。
为了验证这一假说，Noble等在23例哮喘患者和18例健康对照者中进行了一项有关RHML的交叉分层研究。研究使用温湿度仪测定吸气和呼气时的气道温度，并允许精确地控制吸气状态和通气模式。哮喘患者同时测定呼气末NO浓度、痰嗜酸性粒细胞百分数和呼气末冷凝气PH值。研究发现哮喘患者的RHML较对照者明显升高，而且哮喘患者的RHML与痰嗜酸性粒细胞百分数相关。
作者认为，气道温度与细胞测定之间的相关性，提示这种无创性气道温湿度可以作为哮喘患者慢性气道炎症程度的敏感指标。
（韩伟 青岛大学附属青岛市立医院东院呼吸科 266071 摘译）
( Eur Respir J 2007; 29:676-681)
Respiratory heat and moisture loss is associated with eosinophilic inflammation in asthma
D. D. Noble, J. B. McCafferty, A. P. Greening and J. A. Innes
Increased mucosal vascularity is a hallmark of airway inflammation in asthma. It was hypothesised that this would lead to a detectable increase in respiratory heat and moisture loss (RHML), which would reflect the degree of airway inflammation present.
A total of 23 subjects with asthma and 18 healthy controls had RHML measured in a cross-sectional study. The measurements were made using a device that combines temperature and humidity measurement during inspiration and expiration and allows precise control over inspirate conditions and ventilatory pattern. The subjects with asthma underwent parallel measurements of exhaled nitric oxide, sputum eosinophil percentage and exhaled breath condensate pH.
Mean±SD RHML was elevated in patients with asthma (98.1±7.3 J·L–1) compared with control subjects (91.9±4.5 J·L–1). RHML measurement in asthma correlated with sputum eosinophil percentage.
This novel correlation between thermal and cellular measurements in asthma suggests that both of these noninvasive indices are sensitive to the degree of underlying chronic airway inflammation. （Eur Respir J 2007; 29:676-681）
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以呼出气体中NO含量为指标指导慢性支气管哮喘治疗
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