Motegi T, Kida K
Pulmonary Division, Tokyo Metropolitan Geriatric Hospital, Japan.
Nihon Kokyuki Gakkai Zasshi. 1999 Aug;37(8):608-13.
We tested the hypothesis that serum IgE concentrations may be influenced by the severity of respiratory symptoms, impairment of pulmonary functions, and smoking history in elderly patients with bronchial asthma and/or chronic obstructive pulmonary disease (COPD). A total of 325 elderly outpatients aged over 65 years were enrolled in the study: 112 (22 men, 90 women) with bronchial asthma (BA), 135 (118 men, 17 women) with COPD, and 78 (56 men, 22 women) with both COPD and asthma (COPD/BA). The mean ages for the 3 groups were 74.3,76.0 and 76.6 years, respectively; the age differential was not significant. As a group, the male subjects displayed higher serum IgE concentrations than the female subjects. Also, ex-smokers and current smokers showed higher serum IgE concentrations than patients who had never smoked, and patients in the BA group had higher serum IgE concentrations than those in the COPD or COPD/BA groups. Although serum IgE concentrations were increased in BA patients with decreased FEV1.0 levels, the reverse was observed in the COPD patients. Peripheral blood eosinophil counts for men and women were higher in the BA group than in the COPD group. A positive correlation between serum IgE concentration and eosinophil count was observed in the BA group. Although bronchial asthma and COPD in the elderly have been considered to be pathologically similar, the findings of our study suggested they are probably different in terms of serum IgE concentration, pulmonary function, and smoking history.
血清免疫球蛋白E(IgE)浓度可能受老年支气管哮喘和/或慢性阻塞性肺疾病(COPD)患者的呼吸道症状严重程度、肺功能损害及吸烟史的影响。共有325名65岁以上的老年门诊患者参与了本研究:112例(22名男性,90名女性)患有支气管哮喘(BA),135例(118名男性,17名女性)患有COPD,78例(56名男性,22名女性)同时患有COPD和哮喘(COPD/BA)。这3组患者的平均年龄分别为74.3岁、76.0岁和76.6岁;年龄差异不显著。总体而言,男性受试者的血清IgE浓度高于女性受试者。此外,既往吸烟者和当前吸烟者的血清IgE浓度高于从不吸烟者,BA组患者的血清IgE浓度高于COPD组或COPD/BA组患者。虽然FEV1.0水平降低的BA患者血清IgE浓度升高,但COPD患者中观察到的情况则相反。BA组男性和女性的外周血嗜酸性粒细胞计数均高于COPD组。BA组中观察到血清IgE浓度与嗜酸性粒细胞计数呈正相关。虽然老年支气管哮喘和COPD在病理上被认为相似,但我们的研究结果表明,它们在血清IgE浓度、肺功能和吸烟史方面可能存在差异。