Zhang Jing, Wang Xinmao, Chen Yahong, Yao Wanzhen
Department of Respiratory Diseases, Peking University Third Hospital.
Department of Respiratory Diseases, Beijing Tongren Hospital, Beijing, People's Republic of China.
Respir Care. 2015 Feb;60(2):251-8. doi: 10.4187/respcare.03519. Epub 2014 Oct 21.
The role of exhaled H2S as a marker of airway inflammation and its relationship with COPD severity remain to be determined.
Airway inflammation was classified in 77 COPD subjects based on the presence of inflammatory cells in induced sputum. We investigated the association between disease phenotype and exhaled H2S, lung function, and plasma levels of several inflammatory factors, including tumor necrosis factor alpha, interleukin-8, and leukotriene B4.
In total, 33.77% of enrolled COPD subjects were diagnosed with eosinophilia. These subjects had a longer disease course, smoked fewer cigarettes, and experienced more frequent exacerbation events before study enrollment. However, they also had worse lung function and larger residual volume, they demonstrated greater changes in FEV1 following bronchodilator inhalation. Although levels of plasma inflammatory factors did not significantly differ between subjects with and without eosinophilia, subjects without eosinophilia had significantly higher levels of exhaled H2S (9.19±2.74 vs 7.24±1.68 parts per billion, P=.01). Furthermore, exhaled H2S levels were negatively correlated with induced sputum eosinophils (r=-0.45, P=.05), and positively correlated with inspiratory capacity in COPD subjects (r=0.51, P=.026), but did not correlate significantly with plasma inflammatory factors. A cut-off value of 7.10 parts per billion of exhaled H2S predicted a non-eosinophilic phenotype with 68.6% sensitivity and 77.9% specificity.
Exhaled levels of H2S were lower in subjects with eosinophilia. Increased levels of exhaled H2S predicted a non-eosinophilic phenotype in our study population.
呼出硫化氢作为气道炎症标志物的作用及其与慢性阻塞性肺疾病（COPD）严重程度的关系仍有待确定。
根据诱导痰中炎症细胞的存在情况，对77例COPD患者的气道炎症进行分类。我们研究了疾病表型与呼出硫化氢、肺功能以及包括肿瘤坏死因子α、白细胞介素 - 8和白三烯B4在内的几种炎症因子血浆水平之间的关联。
总共33.77%的入组COPD患者被诊断为嗜酸性粒细胞增多。这些患者病程更长，吸烟量更少，且在研究入组前经历更频繁的急性加重事件。然而，他们的肺功能也更差，残气量更大，吸入支气管扩张剂后第一秒用力呼气容积（FEV1）的变化更大。虽然嗜酸性粒细胞增多患者和无嗜酸性粒细胞增多患者的血浆炎症因子水平无显著差异，但无嗜酸性粒细胞增多患者的呼出硫化氢水平显著更高（9.19±2.74 vs 7.24±1.68十亿分之一，P = 0.01）。此外，呼出硫化氢水平与诱导痰嗜酸性粒细胞呈负相关（r = -0.45，P = 0.05），与COPD患者的吸气容量呈正相关（r = 0.51，P = 0.026），但与血浆炎症因子无显著相关性。呼出硫化氢7.10十亿分之一的临界值预测非嗜酸性粒细胞表型的敏感性为68.6%，特异性为77.9%。
嗜酸性粒细胞增多患者的呼出硫化氢水平较低。在我们的研究人群中，呼出硫化氢水平升高预测非嗜酸性粒细胞表型。
