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支气管哮喘气道炎症和哮喘控制与肺炎支原体感染的相关性研究

Correlations of mycoplasma pneumoniae infection with airway inflammation and asthma control in patients with bronchial asthma

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【作者】 周阿旺戴元荣沈雪艳陈志华沈华浩

【Author】 ZHOU A-wang;DAI Yuan-rong;SHEN Xue-yan;CHEN Zhi-hua;SHEN Hua-hao;Department of Respiratory Disease,the Second Affiliated Hospital of Zhejiang University Medical College;

【机构】 浙江大学医学院附属第二医院呼吸科温州医科大学附属第二医院呼吸科绍兴文理学院附属医院呼吸科

【摘要】 目的探讨支气管哮喘(简称哮喘)患者的气道炎症、哮喘控制与肺炎支原体(MP)感染的关系。方法选择2010年6月至2012年10月浙江大学医学院附属第二医院收治的支气管哮喘急性发作期患者114例和缓解期患者116例,检测两组MP特异IgM和IgG,比较其感染率;比较两组中有、无MP感染患者间痰嗜酸粒细胞(EOS)计数、血清总免疫球蛋白E(IgE)、第一秒用力呼气容积占预计值百分比(FEV1%pred)及哮喘控制测试(ACT)评分;并行相关性分析。结果急性发作患者MP感染率(41.2%)明显高于缓解期患者(22.4%,P<0.05);MP感染患者痰EOS计数、血清总IgE均高于无MP感染患者,而FEV1%pred及ACT评分均低于无MP感染患者,两者差异有统计学意义(P<0.05);两组感染率与各组感染阳性患者的FEV1%pred、ACT评分呈负相关(r=-0.356、-0.456),与各组MP感染阳性患者的血清总IgE及痰EOS计数呈正相关(r=0.756、0.356)。结论无论哮喘急性发作期还是缓解期,MP感染都是不可忽视的因素,且相较于慢性缓解期,更多见于哮喘急性发作期。

【Abstract】 Objective To explore the relationship between Mycoplasma pneumoniae infection and asthma control in patients with bronchial asthma,and to find the possible mechanism. Methods A total of 114 asthmatic patients with acute exacerbation and 116 patients in remission stage were selected in this study. Serum IgM and IgG specific to M. pneumoniae were detected in all the patients and the infection rates of M. pneumonia were compared between the two groups of patients. The eosinophilic( EOS) ratio in the sputum,total serum IgE,FEV1% pred and ACT score were also analyzed and compared between the two groups. Results We found that 41. 2% of patients with acute exacerbation were infected by M. pneumoniae,significantly higher than that in patients in remission stage(22. 4%)( P < 0. 05). Moreover,the EOS ratio in the sputum and total serum IgE were significantly higher while FEV1% pred and ACT score were significantly lower in patients with M.pneumoniae infection than those in patients without infection. Conclusion M. pneumonia infection cannot be ignored both in patients with acute exacerbation and in remission stage,especially in the former. M. pneumonia infection might enhance eosinophils recuitment,resulting in a bad asthma control.

【基金】 浙江省自然科学基金(Y2110114)
  • 【文献出处】 中国实用内科杂志 ,Chinese Journal of Practical Internal Medicine , 编辑部邮箱 ,2014年08期
  • 【分类号】R562.25
  • 【被引频次】17
  • 【下载频次】187
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