Papi A, Romagnoli M, Baraldo S, Braccioni F, Guzzinati I, Saetta M, Ciaccia A, Fabbri L M
Research Center on Asthma and COPD, University of Ferrara, Ferrara, Italy.
Am J Respir Crit Care Med. 2000 Nov;162(5):1773-7. doi: 10.1164/ajrccm.162.5.9910112.
We investigated the relationship between the reversibility of airflow limitation, the concentration of nitric oxide (NO) in exhaled air, and the inflammatory cells in the sputum of patients with stable chronic obstructive pulmonary disease (COPD). We examined nine normal healthy control subjects and 20 nonatopic patients with COPD. Ten patients had no reversibility of airflow limitation (increase in FEV(1) of < 12% and < 200 ml after 200 microg of inhaled salbutamol), and 10 patients had partial reversibility of airflow limitation (increase in FEV(1) of < 12% but > 200 ml after 200 microg of inhaled salbutamol). Exhaled NO levels were higher in COPD patients with partial reversibility of airflow limitation than in those with no reversibility of airflow limitation (median 24 [interquartile range 15.3 to 32] ppb versus 8.9 [4.6 to 14.7] ppb; p < 0.01). Compared with healthy control subjects, only COPD patients with partial reversibility of airflow limitation had increased concentrations of sputum eosinophils. We conclude that, in patients with stable COPD, even a partial bronchodilator response to inhaled salbutamol is associated with increased exhaled NO and sputum eosinophilia, suggesting that these patients may have a different response to treatment than do those without reversible airflow limitation.
我们研究了稳定期慢性阻塞性肺疾病（COPD）患者气流受限的可逆性、呼出气中一氧化氮（NO）浓度与痰液中炎症细胞之间的关系。我们检查了9名正常健康对照者和20名非特应性COPD患者。10例患者气流受限无可逆性（吸入200μg沙丁胺醇后FEV(1)增加<12%且<200ml），10例患者气流受限有部分可逆性（吸入200μg沙丁胺醇后FEV(1)增加<12%但>200ml）。气流受限有部分可逆性的COPD患者的呼出气NO水平高于气流受限无可逆性的患者（中位数24[四分位间距15.3至32]ppb对8.9[4.6至14.7]ppb；p<0.01）。与健康对照者相比，只有气流受限有部分可逆性的COPD患者痰液嗜酸性粒细胞浓度增加。我们得出结论，在稳定期COPD患者中，即使对吸入沙丁胺醇有部分支气管扩张反应也与呼出气NO增加和痰液嗜酸性粒细胞增多有关，这表明这些患者对治疗的反应可能与无可逆性气流受限的患者不同。
