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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。
Objective To investigate the relationship between airway inflammation and asthma control and Mycoplasma pneumoniae (MP) infection in patients with bronchial asthma (asthma). Methods From June 2010 to October 2012, 114 patients with acute exacerbation of bronchial asthma and 116 patients with remission were admitted to the Second Affiliated Hospital of Medical College of Zhejiang University. The specific IgM and IgG were detected in two groups, and their infection rates were compared. The numbers of sputum eosinophils (EOS), serum total immunoglobulin E (IgE), percentage of first-second forced expiratory volume (FEV1% pred) and asthma control were compared between the two groups Test (ACT) score; parallel correlation analysis. Results The incidence of MP infection in patients with acute exacerbation (41.2%) was significantly higher than that in patients without exacerbation (22.4%, P <0.05). The sputum EOS count and total serum IgE in patients with MP infection were higher than those without MP infection, while FEV1% pred and ACT (P <0.05). The infection rates of the two groups were negatively correlated with the FEV1% pred and ACT scores of patients with positive infection (r = -0.356, -0.456 ) Was positively correlated with total serum IgE and sputum EOS count in patients with positive MP infection (r = 0.756,0.356). Conclusions Regardless of the acute or remission period of asthma, MP infection is a factor that can not be ignored. Compared with the chronic remission period, it is more common in acute exacerbation of asthma.