Loukides Stelios, Bouros Demosthenes, Papatheodorou Georgios, Lachanis Stephanos, Panagou Panos, Siafakas Nikolaos M
Department of Pneumonology, Athens Army General Hospital, Athens, Greece.
Chest. 2002 Jan;121(1):81-7. doi: 10.1378/chest.121.1.81.
To determine the concentration of exhaled H(2)O(2) in patients with bronchiectasis, and to study the relationship between levels of exhaled H(2)O(2), extent of disease, symptoms score, spirometry, and cellular composition obtained from induced sputum; furthermore, to account for possible confounding effects of inhaled corticosteroids (ICS) usage, long-term oral antibiotic treatment, and chronic colonization with Pseudomonas aeruginosa.
Cross-sectional study.
Thirty patients with steady-state bronchiectasis.
Mean (95% confidence interval [CI]) exhaled H(2)O(2) levels were significantly elevated in patients with bronchiectasis compared to normal subjects: 1.1 (0.87 to 1.29) microM vs 0.3 (0.19 to 0.36) microM, respectively (p < 0.0001). Patients treated with ICS had similar values as steroid-naïve patients. The group of patients with P aeruginosa colonization showed a significantly increased concentration of H(2)O(2) compared to the group without P aeruginosa colonization. Patients receiving long-term oral antibiotic treatment had significantly higher values of H(2)O(2) compared to those not receiving antibiotics. There was a significant positive correlation between H(2)O(2) and either the percentage of neutrophils in induced sputum or the extent of the disease as defined by high-resolution CT. A significant negative correlation was found between H(2)O(2) and FEV(1) percent predicted. Finally, there was a significant positive correlation between H(2)O(2) and the symptoms score.
Patients with bronchiectasis in stable condition showed increased levels of exhaled H(2)O(2). The above-mentioned levels were not decreased either by ICS or long-term oral antibiotic treatment, but were significantly affected by chronic colonization with P aeruginosa. H(2)O(2) levels could be an indirect index of neutrophilic inflammation, impairment of lung function, and extension and severity of the disease.
测定支气管扩张症患者呼出的过氧化氢（H₂O₂）浓度，并研究呼出H₂O₂水平、疾病程度、症状评分、肺功能测定以及诱导痰细胞组成之间的关系；此外，还要考虑吸入糖皮质激素（ICS）使用、长期口服抗生素治疗以及铜绿假单胞菌慢性定植可能产生的混杂效应。
横断面研究。
30例处于病情稳定期的支气管扩张症患者。
与正常受试者相比，支气管扩张症患者呼出的H₂O₂水平均值（95%置信区间[CI]）显著升高：分别为1.1（0.87至1.29）微摩尔/升和0.3（0.19至0.36）微摩尔/升（p < 0.0001）。接受ICS治疗的患者与未使用类固醇的患者数值相似。与无铜绿假单胞菌定植的患者组相比，有铜绿假单胞菌定植的患者组H₂O₂浓度显著升高。接受长期口服抗生素治疗的患者H₂O₂值显著高于未接受抗生素治疗的患者。H₂O₂与诱导痰中中性粒细胞百分比或高分辨率CT所定义的疾病程度之间存在显著正相关。H₂O₂与预测的第一秒用力呼气容积（FEV₁）百分比之间存在显著负相关。最后，H₂O₂与症状评分之间存在显著正相关。
病情稳定的支气管扩张症患者呼出的H₂O₂水平升高。上述水平并未因ICS或长期口服抗生素治疗而降低，但受铜绿假单胞菌慢性定植的显著影响。H₂O₂水平可能是中性粒细胞炎症、肺功能损害以及疾病扩展和严重程度的间接指标。
