香烟烟雾对支气管哮喘患者气道炎性反应及肺功能的影响

目的 探讨香烟烟雾对支气管哮喘（简称哮喘）患者气道炎性反应及肺功能的影响。方法 哮喘香烟烟雾暴露组患者25例，哮喘非香烟烟雾暴露组患者22例，对照组20例，诱导痰检测痰液中各种炎性细胞百分比及血清中白细胞介素(IL)-8和IL-4的含量，所有入选者均测定肺功能指标第1秒用力呼气容积占预计值百分比（FEV1％预计值）、第1秒用力呼气容积占用力肺活量百分比(FEV1/FVC％)。结果 哮喘香烟烟雾暴露组患者痰液中以中性粒细胞浸润为主，而哮喘非香烟烟雾暴露组患者以嗜酸粒细胞浸润为主。哮喘香烟烟雾暴露组患者外周血血清中IL-8和IL-4水平分别为(277.02±71.37)、(171.69±31.01) ng/L，明显高于哮喘非香烟烟雾暴露组的(158.88±21.95)、(111.42±21.69)ng/L和对照组的(116.78±71.37)、(73.94±15.72) ng/L，差异均有统计学意义(P＜0.01)。哮喘香烟烟雾暴露组患者肺功能指标FEV1％预计值和FEV1/FVC％分别为(51.12±13.30)％、(49.16±11.09)％,均低于对照组的(95.50±10.11)％、(83.18±6.04)％和哮喘非香烟烟雾暴露组的(81.81±5.82)％、(79.00±3.86)％，差异均有统计学意义(P＜0.01)。血清中IL-8水平与痰液中中性粒细胞百分比呈正相关(r=0.742，P＜ 0.01)，与FEV1％预计值呈负相关(r=-0.739，P＜0.01)。结论 香烟烟雾可能通过促进哮喘患者中性粒细胞趋化因子I_8的产生而影响气道炎性反应，加速其肺功能的受损。

Influence of the cigarette smoke in the airway inflammation and pulmonary function of the asthmatic patients

Objective To explore the influence of the cigarette smoke in the airway inflammation and pulmonary function of the asthmatic patients. Methods Twenty-five cases of asthmatic patients with cigarette smoke exposure, 22 cases of asthmatic patients without cigarette smoke exposure and 20 cases of normal control persons were involved in this study. The proportion of various inflammatory cells in the induced sputum, the levels of serum interleukin (IL)-8 and IL-4 and lung function (FEV1％ expected value,FEV1/ＦVC％ ) were detected. Results The infiltrating of neutrophils was primarily found in sputum of the asthmatic patients with cigarette smoke exposure, but the infiltrating of eosinophils was mainly in sputum of the asthmatic patients without cigarette smoke exposure. The levels of serum IL-8 and IL-4 of peripheral blood of asthmatic patients with cigarette smoke exposure [(277.02 ±71.37), (171.69 ±31.01) ng/L] were significantly higher than those in asthmatic patients without cigarette smoke exposure [(158.88 ± 21.95 ),( 111.42 ± 21.69 ) ng/L] and normal control persons [( 116.78 ± 71.37 ), (73.94 ± 15.72 ) ng/L] (P ＜ 0.01 ).The FEV1％ expected value and FEV1/FVC％ of the asthmatic patients with cigarette smoke exposure [(51.12 ± 13.30) ％, ( 49.16 ± 11.09 )％] was lower than those of asthmatic patients without cigarette smokeexposure [(81.81 ± 5.82)％, (79.00 ± 3.86)％] and normal control persona [(95.50 ± 10.11 )％, (83.18 ±6.04)％] (P ＜ 0.01 ). The level of serum IL-8 was positively correlated to the neutrophils percentage in the induced sputum (r =0.742,P＜ 0.01 ) ,while negatively correlated to the FEV1％ expected value(r =-0.739,P ＜ 0.01 ). Conclusion Cigarette smoke may influence the airway inflammation of the asthmatic patients and accelerate the deterioration of their lung function by promoting the producing of IL-8.