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肺炎支原体感染与哮喘控制、哮喘严重程度和气道阻塞部位无关。

Infection with Mycoplasma pneumoniae is not related to asthma control, asthma severity, and location of airway obstruction.

机构信息

Tuberculosis and Lung Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.

出版信息

Int J Gen Med. 2010 Dec 20;4:1-4. doi: 10.2147/IJGM.S15867.

Abstract

BACKGROUND

Mycoplasma pneumoniae is an organism that reportedly has a strong relationship to asthma. However, asthma severity and location of airway obstruction have not been compared between asthmatic patients with and without evidence for remote mycoplasma infection.

OBJECTIVES

The aim of this research was to study the relationship between previous M. pneumoniae infections in asthmatic patients and presence of any predilection for the involvement of central or peripheral airways, the severity of the disease, and asthma control.

METHODS

Sixty-two patients with asthma were assessed by a validated asthma control test (ACT). All patients underwent spirometry and lung volume studies by body plethysmography. The forced expiratory volume in 1 second (FEV(1)), forced vital capacity (FVC), total lung capacity (TLC), residual volume (RV), and functional residual capacity (FRC) were measured. An oropharyngeal swab was obtained for polymerase chain reaction analysis to detect the mycoplasma antigen. Moreover, blood samples were obtained to measure the titration of antimycoplasma immunoglobulin M (IgM) and IgG antibodies. The asthmatic patients with a positive IgG for mycoplasma and negative PCR and negative IgM antibody were considered to have remote history of mycoplasma infection. The relationship between the asthma control using ACT score and pulmonary function variables were compared in patients with and without evidence for remote mycoplasma infection.

RESULTS

The incidence of postnasal drip was higher among the patients with asthma who had no evidence for remote mycoplasma infection (61.3% vs 32%, P = 0.035). The median ACT score was 16.5 (11-22) and 20 (13.75-24) in patients with and without remote M. pneumoniae infection, respectively (P > 0.05). In addition, the medians of the predicted values of the pulmonary function test parameters (FEV(1), FEV(1)/FVC, FRC, FRC/TLC, RV/TLC, maximal mean expiratory flow 25%-75%, forced expiratory flow [FEF] 50%, and FEF 75%) and actual values of 5 Hz and 20 Hz resistance were not different between asthmatic patients with and without evidence of mycoplasma infection (P > 0.05).

CONCLUSIONS

The present study revealed that the asthma control status and parameters of lung function tests did not differ between asthmatic patients with and without evidence of chronic M. pneumoniae infection. The latter indicates the similar location of airway obstruction and comparable severity of asthma between the two groups.

摘要

背景

肺炎支原体据报道与哮喘有很强的关系。然而,哮喘的严重程度和气道阻塞的位置在有和没有支原体感染的哮喘患者之间尚未进行比较。

目的

本研究旨在研究哮喘患者既往肺炎支原体感染与中央或外周气道受累的易感性、疾病严重程度和哮喘控制之间的关系。

方法

62 例哮喘患者通过验证的哮喘控制测试(ACT)进行评估。所有患者均接受了肺活量测定和体描法肺量测定。测量第 1 秒用力呼气量(FEV1)、用力肺活量(FVC)、总肺容量(TLC)、残气量(RV)和功能残气量(FRC)。采集咽拭子进行聚合酶链反应分析以检测支原体抗原。此外,还采集血样测量抗支原体免疫球蛋白 M(IgM)和 IgG 抗体滴度。肺炎支原体 IgG 阳性而 PCR 阴性和 IgM 抗体阴性的哮喘患者被认为有支原体感染的既往史。比较有和无支原体感染证据的患者使用 ACT 评分和肺功能变量之间的关系。

结果

无支原体感染证据的哮喘患者中后鼻滴涕的发生率更高(61.3% vs 32%,P = 0.035)。有和无支原体感染证据的患者的 ACT 评分中位数分别为 16.5(11-22)和 20(13.75-24)(P > 0.05)。此外,FEV1、FEV1/FVC、FRC、FRC/TLC、RV/TLC、25%-75%最大呼气中期流量、50%用力呼气流量(FEF)和 75% FEF 的预测值和 5 Hz 和 20 Hz 阻力的实际值在有和无支原体感染的哮喘患者之间没有差异(P > 0.05)。

结论

本研究表明,有和无支原体感染证据的哮喘患者的哮喘控制状况和肺功能测试参数没有差异。后者表明两组气道阻塞的位置相似,哮喘的严重程度相当。

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