Coexistence of Th1/Th2 and Th17/Treg imbalances in patients with allergic asthma

Background  Recent recognition is that Th2 response is insufficient to fully explain the aetiology of asthma. Other CD4⁺ T cells subsets might play a role in asthma. We investigated the relative abundance and activities of Th1, Th2, Th17 and CD4⁺CD25⁺ Treg cells in patients with allergic asthma.

Methods  Twenty-two patients with mild asthma, 17 patients with moderate to severe asthma and 20 healthy donors were enrolled. All patients were allergic to house dust mites. Plasma total IgE, pulmonary function and Asthma Control Questionnaire were assessed. The proportions of peripheral blood Th1, Th2, Th17 and CD4⁺CD25⁺ Treg cells were determined by flow cytometry. The expression of cytokines in plasma and in the culture supernatant of peripheral blood mononuclear cells was determined by enzyme linked, immunosorbent assay.

Results  The frequency of blood Th2 cells and IL-4 levels in plasma and culture supernatant of peripheral blood mononuclear cells were increased in all patients with allergic asthma. The frequency of Th17 cells and the plasma and culture supernatant levels of IL-17 were increased, whereas the frequency of CD4⁺CD25⁺ Treg cells and plasma IL-10 levels were decreased in patients with moderate to severe asthma. Dermatophagoides pteronyssinus specific IgE levels were positively correlated with the percentage of blood Th2 cells and plasma IL-4 levels. Forced expiratory volume in the first second was negatively correlated with the frequency of Th17 cells and plasma IL-17 levels, and positively correlated with the frequency of Treg cells. However, mean Asthma Control Questionnaire scores were positively correlated with the frequency of Th17 cells and plasma IL-17 levels, and negatively correlated with the frequency of Treg cells.

Conclusions  Imbalances in Th1/Th2 and Th17/Treg were found in patients with allergic asthma. Furthermore, elevated Th17 cell responses, the absence of Tregs and an imbalance in Th17/Treg levels were associated with moderate to severe asthma. 

     

Effect of Tumor Necrosis Factor-α Antagonism in Asthma： a Meta-analysis of the Published Literature

It remains controversial whether tumor necrosis factor(TNF)-α antagonism is effective for asthma.This meta-analysis was performed to evaluate efficacy of TNF-α antagonism in treatment of patients with asthma.MEDLINE,EMBASE,LILACS,and CINAHL databases were searched for English-language studies published through January 3,2010.Randomized-controlled trials comparing TNF-α antagonism with control therapy were selected.For each report,data were extracted in relation to the outcomes analyzed:asthma exacerbation,asthma quality of life questionnaire scores,and forced expiratory volume in 1 second.Four assessable trials were identified including 641 patients with asthma.TNF-α antagonism therapy was superior to control therapy in preventing exacerbations in asthmatics [pooled odds ratio 0.52(95% confidence interval 0.29-0.88),P=0.02];however,there was a nonsignificant reduction in asthma quality of life questionnaire scores [0.23(0 to 0.47),P=0.05],forced expiratory volume in 1 second [0.03,(-0.14 to 0.10),P=0.74] when analyzed using standardized mean differences.TNF-α antagonism was superior to control chemotherapy in terms of asthma exacerbation,but not asthma quality of life questionnaire scores or forced expiratory volume in 1 second.     

Evaluation of asthma control: a questionnaire-based survey in China

Background Little is known about asthma control and perception of asthma among asthmatic patients in China.This study marked the first survey conducted on a national scale that aimed at obtaining baseline information on asthma control and patients＇ perception of asthma and providing a point of reference for future studies.Methods This face-to-face,questionnaire-based survey was conducted from April 2007 to March 2008 with 3 069 asthmatic patients from the respiratory outpatient clinics of 36 general hospitals located in 10 geographically dispersed cities.Results Consistent with the Global Initiative for Asthma （GINA） guidelines,28.7% and 45.0% of our patients achieved control and partial control,respectively.Of the patients in the study,only 21.8% had used a peak flow meter （PFM）,and 6.6% of these patients used it daily.Inhaled corticosteroids （ICS） plus a long-acting β2 agonist （LABA） and ICS were the two most common medication regimens and were used in 45.6% and 30.4% of patients,respectively.Asthma had a significant effect on the patients＇ life and work.A considerable number of hospitalizations,emergency department visits,and sick days were observed.Conclusion Despite improvements in asthma control and ICS and PFM compliance compared with past literature,the current level of asthma control countrywide continues to fall short of the goals set in the GINA.     

Effect of ligustrazine injection on levels of interleukin-4 and interferon-gamma in patients with bronchial asthma

Objective： To explore the effect of ligustrazine injection （LI） on serum levels of interleukin-4 （IL-4） and interferon- -γ （IFN- -γ ） in patients with bronchial asthma and determine the mechanism of action of LI in preventing and treating asthma. Methods： Sixty-eight patients with mild or moderate bronchial asthma were assigned to two groups equally according to their sequence number, odd or even. The conventional treatment was administered to both groups, and LI was given to the treatment group by ultrasonic spray inhalation twice a day but not to the control group. The therapeutic course for all was 2 weeks. Further, 30 healthy subjects who had no history of smoking were enrolled as the normal control group. The clinical condition scores, frequency of attacks and dosage of Terbutaline inhaled were scored and recorded on the first day of hospitalization （before treatment） and after treatment. At the same time, the indexes of lung function, including forced expiratory volume in one second （FEV1）, forced expiratory volume in one second to forced vital capacity ratio （FEV1%） and the peak expiratory flow （PEF） were determined before treatment. The levels of IL-4 and IFN--γ in peripheral blood were detected by ELISA before and after treatment, and compared with that of the healthy control group. Results： After treatment, the clinical condition scores were found to be lower, indexes of lung function were elevated, but serum level of IL-4 and ratio of IL-4/IFN-γwere reduced in both groups, showing significant differences as compared to those before treatment （P〈0.05）. However, the changes in all the indexes were more significant in the treatment group than in the control group, also showing statistical significance （P〈0.05）. No significant difference was revealed when IFN--γ levels were compared before and after treatment in both groups, though a lowering trend could be seen, significant difference could not be found in the comparison of IFN--γ levels between groups a     

Effect of Ligustrazine Injection on Levels of Interleukin-4 and Interferon-γ in Patients with Bronchial Asthma

Objective:To explore the effect of ligustrazine injection (LI) on serum levels of interleukin-4 (IL-4) and interferon-γ (IFN-γ) in patients with bronchial asthma and determine the mechanism of action of LI in preventing and treating asthma.Methods:Sixty-eight patients with mild or moderate bronchial asthma were assigned to two groups equally according to their sequence number,odd or even.The conventional treatment was administered to both groups,and LI was given to the treatment group by ultrasonic spray inhalation twice a day but not to the control group.The therapeutic course for all was 2 weeks.Further,30 healthy subjects who had no history of smoking were enrolled as the normal control group.The clinical condition scores,frequency of attacks and dosage of Terbutaline inhaled were scored and recorded on the first day of hospitalization (before treatment) and after treatment.At the same time,the indexes of lung function,including forced expiratory volume in one second (FEV1),forced expiratory volume in one second to forced vital capacity ratio (FEV1%) and the peak expiratory flow (PEF) were determined before treatment.The levels of IL-4 and IFN-γ in peripheral blood were detected by ELISA before and after treatment,and compared with that of the healthy control group.]Results:After treatment,the clinical condition scores were found to be lower,indexes of lung function were elevated,but serum level of IL-4 and ratio of IL-4/IFN-γ were reduced in both groups,showing significant differences as compared to those before treatment (P＜0.05).However,the changes in all the indexes were more significant in the treatment group than in the control group,also showing statistical significance (P＜0.05).No significant difference was revealed when IFN-γ levels were compared before and after treatment in both groups,though a lowering trend could be seen,significant difference could not be found in the comparison of IFN- γ levels between groups after treatment (P＞0.05).Conclusion:LI shows good clinical effect in treating bronchial asthma,and its mechanism might be related to the suppression of the synthesis of IL-4,thus leading to the inhibition of TH2 cell subset preponderant response and immune equilibrium regulation.     

The association analysis of FcεRⅠβ with allergic asthma in a Chinese population

Objective To investigate the link between the polymorphism of -109 and Glu237 in the high-affinity IgE receptor β （FcεRⅠβ） gene and susceptibilty to allergic asthma in a Chinese population.Method Blood samples from 216 allergic asthma patients and 198 age- and sex-matched controls were studied. A-109C/T and a coding variant Glu237Gly in FcεRⅠβ were detected with polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP). Results The genotype frequencies were 0.403 for -109T/T, 0.491 for －109T/C and 0.106 for －109C/C in allergic asthma in a Chinese population. No significant difference in the distribution of －109C/T polymorphism was found between allergic asthma subjects and healthy controls, however, homozygosity for the －109T allele was associated with increased total plasma IgE levels in subjects with allergic asthma (F=4.020,P<0.05). The allele frequency of Gly237 in the patients and control was 0.236 and 0.136 respectively. There was a significant association between the Gly/Gly genotype and allergic asthma. Among allergic asthma patients Gly237 was significantly associated with high IgE levels.Conclusions These results suggest that the Gly237 variant of the FcεRⅠβ gene is involved in the development of allergic asthma. The-109C/T and Glu237Gly polymorphisms are two of the genetic factor identified thus far, which affect total plasma IgE levels of allergic asthma patients in a Chinese population.     

PERSONALITY PATTERNS IN PATIENTS WITH PEPTIC ULCER DISEASE

Personality patterns are thought to playing a quite important role in the pathogenesis of peptic ulcer (PU). In this study psychological profiles of patients with PU (n=160) were analysed, and compared to those with asthma (n=32) and healthy subjests (n=120). The method of study involved the use six questionnaires test of SRQ-D, Y-G, MMPI-AS, MAS, TMI and CLS.The results were as follow: (1) The patients with PU showed higher scores in SRQ-D, TMI, MMPI-AS and CLS than that of control group with statistical significance. (2)More patients with PU and control subjects showed a normal type D personality than patients with asthma; whereas asthma patients showed a type E more often than the control group and PU patients.Our study indicated that PU patients had more or less charactristic traints of anxiety, depression, introversion, alexithymia and type A behavior. These findings suggest that the characteristic personality patterns in patients with PU in Shanghai is more or less the same as that seen in the Western society and Japan. This is the first study for PU from the stand-poind of psychosomatic medicine in Shanghai.     

Effect of Liandouqingmai Recipe on life quality and vascular endothelial injury in patients with coronary heart disease

OBJECTIVE:To observe the effects of Liandouqingmai Recipe on life quality and vascular endothelial injury in patients with coronary heart disease.METHODS:Capitalized 101 patients with coronary heart disease were randomly divided into a treatment group(n=45) treated with Liandouqingmai Recipe and a standard treatment group(control group,n=56).A normal group of 16 healthy persons was additionally set up.Changes in ET-1 and NO levels were measured and Seatle Angina Questionnaire(SAQ) was adopted in studying life quality before and after treatment for two weeks.The data were analyzed with SPSS 16.0 statistic software.RESULTS:The average level of ET-1 in the normal group was lower and NO higher than that of patients with coronary heart disease.There was no significant difference in the average level of ET-1 and NO and in the scores of SAQ [physical limitation(PL),pngina stability(AS),apngina frequency(AF),treatment satisfaction(TS) and disease perception(DP)] between the two groups before treatment(P>0.05).But after treatment,the scores of SAQ(PL,AS,AF,TS,DP) and NO level were higher than those in the control group,and ET-1 average level in the treatment group was lower than that in the control group.The negative relations between PL and ET-1 and between AF and ET-1 were found in this study.CONCLUSION:Liandouqingmai Recipe can raise scores of SAQ and NO level and decline ET level in patients with coronary heart disease on the basis of convertional standard treatment,thus improving vascular endothelial function and life quality.Life quality is related to vascular endothelial function.     

Correlation of eosinophil counts in induced sputum and fractional concentration of exhaled nitric oxide and lung functions in patients with mild to moderate asthma

Background  The airway inflammation could be assessed by some noninvasive approaches. To investigate the value of eosinophil counts in induced sputum and fractional concentration of exhaled nitric oxide (FENO) for the regimen adjustment in patients with asthma, the correlation was analyzed between the two parameters and lung function parameter (forced expiratory volume in one second (FEV₁)).

Methods  Sixty-five outpatients with mild to moderate non-exacerbation asthma from Beijing Chao-Yang Hospital were enrolled as treatment group. Combined medications of inhaled corticosteroids plus long-acting beta-2 agonist were administered for one year. Lung function parameters, eosinophil counts in induced sputum, concentration of exhaled nitric oxide and the Asthma Control Test scores were recorded, at regular intervals in the follow-up period. Twenty-one healthy volunteers were enrolled as control group and underwent examination of eosinophil counts in induced sputum, lung function and concentration of exhaled nitric oxide.

Results  Sixty-three subjects from treatment group completed follow-up period for one year or longer. Mean FEV₁ value of the 63 subjects was (2.75±0.54) L at baseline, (2.97±0.56) L and (3.07±0.52) L at month 3 and month 6, respectively, and maintained as (3.14±0.51) L in the following six months. Mean FENO decreased from (61±25) parts per billion (ppb) at baseline to (32±19) ppb at month 3 (P <0.05), and continued to decrease to (22±12) ppb at month 6, the difference being significant when compared to both baseline and control group ((13±8) ppb). Mean eosinophil counts decreased to (0.032±0.011) ×10⁶/ml at month 3, which was significantly different from baseline ((0.093±0.023) ×10⁶/ml) and the control group ((0.005±0.003) ×10⁶/ml (both P <0.05). The eosinophil counts in induced sputum correlated positively with concentration of FENO in the first six months (all P <0.05). The concentration of FENO had a significant negative correlation with FEV₁ value (all P <0.05) in any time point in the follow-up period. The Asthma Control Test scores were 18±5, 19±7, 23±2, 24±1 and 24±1 at months 1, 3, 6, 9 and 12, respectively, which were significantly different from the score at baseline (14±3) (P <0.05 ). The most rapid clinical effect was observed at the second month after treatment.

Conclusion  Eosinophil counts in induced sputum and FENO are sensitive parameters to detect airway inflammation and may be useful in evaluating the efficacy of treatment and adjusting medication regimens.

     

布地奈德／福莫特罗治疗哮喘为期三个月的非干预性调研

目的 评价和调查布地奈德/福莫特罗常规临床治疗哮喘的疗效和使用情况.方法 开展多中心、开放的、非干预性调查研究,观察哮喘患者使用布地奈德/福莫特罗治疗12周后的哮喘控制情况,以哮喘控制调查问卷(ACQ)与改良的哮喘控制调查问卷(ACQ5)平均分值为主要疗效观察指标.结果 共入选受试者360例,其中成人哮喘228例,儿童哮喘132例.经12周治疗后,所有患者ACQ平均分值由治疗前的2.03(成人2.20,儿童1.74)下降为0.60(成人0.78,儿童0.29),ACQ5平均分值由治疗前2.47(成人2.24,儿童1.76)下降为0.47(成人0.62,儿童0.20),差异均有统计学意义(P<0.0001).结论 布地奈德/福莫特罗在常规临床应用时可以有效地改善哮喘,并达到哮喘的良好临床控制.     

吐纳呼吸操联合穴位贴敷治疗支气管哮喘慢性持续期临床观察

目的 观察吐纳呼吸操联合穴位贴敷治疗哮喘慢性持续期的临床疗效。方法 将60例哮喘慢性持续期患者随机分成对照组和观察组,每组30例;对照组予常规西药治疗配合穴位贴敷,观察组在对照组基础上加用吐纳呼吸操,疗程均为6周;治疗后3个月随访时,记录两组哮喘急性发作次数及呼吸道感染次数;治疗前、治疗后及随访时,采用哮喘控制测试问卷（asthma control test,ACT）评价哮喘控制水平,采用肺功能中用力肺活量（forced vital capacity,FVC）、第1秒用力呼气容积（forced expiratory flow in one second,FEV1）、呼气峰值流量（peak expiratory flow,PEF）占预计值的百分比（FVC%、FEV1%、PEF%）和呼出气一氧化氮（fractional exhaled nitric oxide,FeNO）检测仪评估患者气道通气功能及炎症程度,采用哮喘生活质量量表（asthma quality of life questionnaire,AQLQ）评估患者生活质量。结果 治疗后3个月,观察组哮喘急性发作次数和呼吸道感染次数均低于对照组（P<0.05）。治疗后、随访时,两组ACT评分、FVC%、FEV1%、PEF%、FeNO及AQLQ中活动受限、哮喘状况、心理状况和对刺激原的反应4个维度评分均优于治疗前（P<0.05）,且治疗后观察组各项均显著优于对照组（P<0.05）,随访时观察组ACT评分、FEV1%、FeNO及AQLQ中活动受限、哮喘状况、心理状况3个维度评分优于对照组（P<0.05）。结论 采用吐纳呼吸操联合穴位贴敷治疗能显著提高哮喘慢性持续期患者症状控制水平和肺功能水平,缓解哮喘气道炎症,改善生活质量。     

变应性鼻炎对哮喘患者临床控制及肺通气功能的影响

目的探讨变应性鼻炎对支气管哮喘(简称哮喘)患者临床控制及肺通气功能的影响。方法收集2010年5月—2011年7月解放军总医院呼吸科及耳鼻咽喉头颈外科门诊就诊的63例哮喘和哮喘合并变应性鼻炎患者,将其分为2组,支气管哮喘组(哮喘组)32例,哮喘合并变应性鼻炎组(哮喘并鼻炎组)31例。比较2组间哮喘控制测试(ACT)评分、哮喘控制问卷(ACQ)评分、最近1个月使用沙丁胺醇气雾剂次数、第1秒呼气容积占预计值百分比(FEV_1%)和呼气峰流量占预计值百分比(PEF%)。结果 ACT评分在哮喘组为(19.0±4.7)分,在哮喘并鼻炎组为(16.3±5.6)分;ACQ评分在哮喘组为(1.4±1.1)分,在哮喘并鼻炎组为(2.1±1.3)分;最近1个月使用沙丁胺醇气雾剂次数在哮喘组为0(0,5)次,在哮喘并鼻炎组为4(0,12)次;FEV_1%在哮喘组为(77,7±21.7)%,在哮喘并鼻炎组为(64.7±23.1)%;PEF%在哮喘组为(79.4±26.3)%,在哮喘并鼻炎组为(65.8±22.0)%。与哮喘组比较,哮喘并鼻炎组的AC3评分、FEV_1%和PEF%明显降低(P<0.05),ACQ评分、最近1个月使用沙丁胺醇气雾剂次数明显升高(P<0.05)。结论合并变应性鼻炎不利于哮喘患者的临床控制,可增加哮喘症状及急救用药次数并使其肺通气功能下降。     

Asthma control assessment using asthma control test among patients attending 5 tertiary care hospitals in Saudi Arabia

OBJECTIVE: Evaluation of asthma control using the Asthma Control Test (ACT). METHODS: The ACT was used to assess asthma control among patients with bronchial asthma visiting pulmonary clinics in 5 major tertiary care hospitals in Riyadh, Kingdom of Saudi Arabia. Each hospital had a target of 300 patients to recruit over the period of the study from the 1st September to 30th November 2006. RESULTS: The total number of patients studied was 1,060 patients. Males constituted 442 (42%) and females constituted 618 (58%), the median age was 38.56 years (range 15-75). One third of patients had no formal education. The ACT score revealed uncontrolled asthma in 677 (64%), well-controlled asthma in 328 (31%), and complete controlled in 55 (5%). There are no significant correlations between the age below 40 and above 40 years and level of asthma control (p=0.12). However, the younger age group less than 20 had better control of asthma in comparison with older patients (p=0.0001). There was a significant correlation between level of asthma control and gender, males (44%) had better asthma control than females (30%) (p=0.0001). CONCLUSION: Control of bronchial asthma is still a major concern in our population. Further studies are needed to explore the factors leading to poor asthma control.     

支气管哮喘患者自我管理现状调查分析

目的了解支气管哮喘患者自我管理现状。方法选择四川大学华西医院呼吸科诊治的80例支气管哮喘患者,让患者填写自行设计的"哮喘患者自我管理调查表"以及进行哮喘控制测试(ACT)评分。结果支气管哮喘患者自我管理意识较差,80例哮喘患者中ACT评分低于20分的患者占65%。结论支气管哮喘患者缺乏对疾病的认识与管理,应加强健康教育,提高依从性。     

度普利尤单克隆抗体治疗儿童中重度特应性皮炎的疗效与安全性研究

目的:探讨度普利尤单克隆抗体（单抗）治疗儿童中重度特应性皮炎（AD）的疗效与安全性。方法:采用回顾性分析的方法，纳入2021年4月—2022年10月在天津医科大学第二医院儿科哮喘和过敏专病门诊接受度普利尤单抗治疗16周的中重度AD患儿17例。比较治疗前后各项AD相关临床评估量表及过敏性共病临床指标、外周血嗜酸性粒细胞计数（EOS）、血清总IgE（T-IgE）水平的变化，评估治疗期间达到湿疹面积及严重程度指数从基线到16周降低≥50%（EASI50）和湿疹面积及严重程度指数从基线到16周降低≥90%（EASI90）的患儿比例及研究者整体评估（IGA）评分达到0或1（皮疹清除或几乎清除）的比例，观察治疗期间不良反应与不良事件的发生情况。结果:与基线相比，AD相关评估量表在度普利尤单抗首次注射后2周即出现显著下降（均P<0.01）；治疗8周后，达到EASI50、EASI90（及IGA评分达到0或1的患者比例即明显增加。度普利尤单抗治疗16周后，患者EOS水平总体较基线上升，5例患者血清T-IgE水平较基线下降，但差异无统计学意义。合并哮喘或过敏性鼻炎（AR）患儿的儿童哮喘控制测试／哮喘控制测试（C-ACT/ACT）、哮喘控制问卷（ACQ）、鼻炎视觉模拟（VAS）评分均得到显著改善，呼出气一氧化氮（FeNO）水平及吸入性糖皮质激素（ICS）剂量均较基线显著下降，第1秒用力呼气容积（FEV1）较基线上升（均P<0.05）。合并食物过敏患儿2例，既往食用过敏食物诱发AD皮疹及瘙痒加重的症状得到改善。治疗期间3例出现结膜炎。结论:度普利尤单抗治疗可以显著改善中重度AD儿童及其过敏性共病临床症状，降低FeNO水平及ICS剂量，改善肺功能，并可能降低血清T-IgE水平。治疗期间不良反应少，主要表现为轻中度结膜炎，安全性良好。     

支气管哮喘控制目标临床应用研究分析

目的研究分析2006年全球哮喘防治创议提出的支气管哮喘控制目标的临床应用价值。方法选择支气管哮喘患者33例,治疗并随访观察6个月,给予沙美特罗/氟替卡松作为基础治疗。根据支气管哮喘控制目标调整治疗方案,观察分析临床症状、使用缓解药物次数、肺功能相关指标和患者病情评估问卷评分变化情况。结果所有患者哮喘症状改善,肺功能相关指标有所提高,使用缓解药物次数减少,哮喘控制测试问卷评分上升。结论支气管哮喘控制目标对科学防治支气管哮喘十分有益,应当在基层医院普及和推广。     

接受变应原免疫治疗的哮喘患者疗效评价

目的 调查接受安脱达(Alutard~(R)SQ)变应原免疫疗法(allergen immunotherapy,AIT)治疗患者的治疗效果,包括哮喘控制水平分级、症状评分改善、最大呼气峰流速(PEF)日变异率和心理状态等指标的变化.方法 对我院门诊接受安脱达(Alutard~(R)SQ)AIT治疗的63例疗程≥6个月且其他药物治疗可控的支气管哮喘患者进行调查,分为两组:一组为无其他药物治疗组26例,另一组为有其他药物治疗组37例;于接受AIT治疗前后应用哮喘控制水平分级、哮喘控制测试(asthma contrel test,ACT)和成人哮喘控制评估问卷(adult asthma therapy assessment questionnaire,ATAQ)两种问卷评价哮喘患者的疾病控制水平,并测定PEF日变异率.用宗氏心理评定量表评定患者的心理状态.结果 两组患者治疗后哮喘控制水平分级、ACT评分和ATAQ评分与治疗前比较差异均有统计学意义(P＜0.05).有其他药物治疗组治疗后PEF日变异率、宗氏焦虑评定量表评分与治疗前比较差异均有统计学意义(P＜0.05).结论 支气管哮喘患者接受安脱达(Alutard~(R)SQ)AIT治疗可有效提高疾病的控制水平,从而改善患者的心理状态.     

吸入糖皮质激素联合β_2-受体激动剂治疗中度持续性哮喘的疗效分析

目的 评估比较布地奈德/福莫特罗干粉吸入剂与布地奈德干粉吸入剂+福莫特罗干粉吸入剂治疗中度持续性哮喘的临床疗效.方法用随机、平行、对照研究方法,将46例患者分为使用布地奈德/福莫特罗干粉吸入荆组和使用布地奈德干粉吸入剂+福莫特罗干粉吸入剂组,观察临床症状、缓解药用量、肺功能相关指标和哮喘症状及病情评估问卷评分变化情况.结果两组治疗期间不同治疗时间各疗效指标间差异有统计学意义(P＜0.05),各疗效指标时间与组间交互作用差异有统计学意义(P＜0.01).结论布地奈德/福莫特罗干粉吸入剂和布地奈德干粉吸入剂+福莫特罗干粉吸入剂联合用药均可改善患者的哮喘症状,均具有良好的疗效及安全性.     

支气管哮喘控制水平与焦虑抑郁情绪关系的研究

目的探讨支气管哮喘(简称哮喘)的控制水平与焦虑抑郁情绪的关系,分析哮喘患者焦虑抑郁发生的可能原因。方法入选2012年5月—2013年5月解放军总医院呼吸科门诊62例哮喘患者进行横断面研究,评估其哮喘控制水平、肺功能及焦虑抑郁情绪。采用2008年支气管哮喘防治指南的控制标准评估哮喘控制水平。采用综合医院焦虑抑郁量表(HAD)评测焦虑和抑郁情绪。将62例患者分为完全控制组、部分控制组及未控制组,分析不同哮喘控制水平与患者焦虑抑郁情绪的关系。结果 62例哮喘患者中存在焦虑18例(29.0%),抑郁20例(32·3%),同时存在焦虑和抑郁10例(16.1%)。病程和年龄与抑郁分数之间存在显著正相关(r=0·300,P<0·05;r=0·307,P<0.05),而与焦虑分数之间无显著相关(r=0.222,P>0.05;r=-0.023,P>0.05)。未控制组患者焦虑和抑郁分数和发生率均朗显高于完全控制组及部分控制组(P<0.01,P<0.05)。哮喘控制良好与焦虑和抑郁情绪发生率呈负相关(r值分别为-0.334和-0.416,P<0.01)。ACT评分与焦虑和抑郁分数之间存在显著负相关(r=-0.341,P<0.01;r=-0.464,P<0.01)。ACQ评分与焦虑和抑郁分数之间存在显著正相关(r=0.378,P<0.01:r=0.443,P<0.01)。FEV_1%与焦虑抑郁分数之间无显著相关(r=-0.096,P>0.05;r=-0.126,P>0.05)。PEF%与焦虑抑郁分数之间无显著相关(r=-0.240,P>0.05;r=-0.240,P>0.05)。焦虑组与非焦虑组相比,FEV_1%、PEF%较低,但差异无统计学意义(P>0.05)。抑郁组与非抑郁组相比,FEV_1%、PEF%较低,但差异无统计学意义(P>0.05)。气道炎性指标(FeNO)与焦虑抑郁分数之间无显著相关(r=0.014,P>0.05;r=-0.073,P>0.05)。结论近1/3的哮喘患者伴有焦虑抑郁情绪。哮喘控制水平与患者焦虑抑郁情绪密切相关,哮喘控制不佳可增加患者焦虑和抑郁的发生率。哮喘症状未控制、生活质量下降可能是哮喘患者发生焦虑抑郁情绪的重要原因。焦虑抑郁情况与患者肺功能和气道炎性指标之间无显著相关性。