血浆硫化氢水平与支气管哮喘的相关性研究

目的观察支气管哮喘患者血浆硫化氢（H2S）水平的变化,研究其与支气管哮喘的相关性。方法 70例支气管哮喘分为哮喘缓解期组30例,轻度急性发作期组10例,中度急性发作期组12例,重度急性发作期组18例和正常对照组15例,采用去蛋白法紫外可见分光光度测定血浆H2S水平并检测肺功能和测定诱导痰细胞的计数和分类。结果 15例正常对照组的血浆H2S水平为（73.23±12.85）μmol/L,30例哮喘缓解期组的血浆H2S水平为（57.22±12.62）μmol/L,急性发作期组中轻度（10例）、中度（12例）、重度（18例）的血浆H2S水平分别为（54.18±6.15）μmol/L、（42.30±5.08）μmol/L和（34.15±2.14）μmol/L。急性发作期的血浆H2S水平组显著低于缓解期组（P〈0.01）,而且轻度、中度与重度之间的差异均有统计学意义（F=40.348,P〈0.01）。测试结果表明,H2S水平与支气管哮喘发作有相关性（r=0.723,P〈0.01）。急性发作患者的血浆H2S水平与FEV1.0%预计值（r=0.845,P〈0.01）和诱导痰巨噬细胞%（r=0.816,P〈0.01）呈正相关。与诱导痰细胞总数、中性粒细胞%及诱导痰嗜酸细胞%呈负相关（r=-0.406、-0.892和-0.638,P〈0.01）。结论患者血浆H2S水平降低,与支气管哮喘发生、发展相关,可能参与哮喘的发病,内源性H2S作为一种无创性指标监测疾病的严重程度和活动度具有一定意义。

Plasma level of endogenous hydrogen sulfide in patients with acute asthma

Objective To investigate the chag of endogenous hydrogen sulfide(H2S) in patients with asthma.Methods Levels of serum H2S,lung function and cell differential count in induced sputum were studied in 40 patients with acute exacerbation of asthma,30 patients with stable asthma and 15 health subjects.Results The serum H2S level was(73.23±12.85) μmol/L in controls(15 cases),(57.22±12.62) μmol/L in patients with stable asthma(30 cases),(54.18±6.15) μmol/L in patients with mild of acute exacerbation asthma(10cases),(42.30±5.08) μmol/L in that with moderate of acute exacerbation asthma(12cases),and(34.15±2.14) μmol/L in that with severe of acute exacerbation asthma(18cases),F=40.348,P <0.01.Status of the subjects(in good health,stable asthma,and exacerbation of asthma) was positively correlated with H2S in serum(r=0.723,P<0.01).H2S in serum was positively correlated with FEV110 %(r=0.845,P<0.01) and the percentage of sputum macophages(r=0.816,P<0.01).While it was negatively correlated with total count of sputum cells(r=-0.406,P<0.01),the percentage of sputum neutrophils(r=-0.892,P <0.01) and the percentage of sputum eosinophiles(r=-0.638,P<0.01).Conclusion Endogenous H2S may be involved in the pathogenesis of airway obstruction in asthma and may be a noninvasive marker of disease activity and severity.