在环境相对霉菌指数值高的苏格兰家庭中，哮喘成年患者的第一秒用力呼气容积百分比降低。
Decreased FEV1 % in asthmatic adults in Scottish homes with high Environmental Relative Moldiness Index values.
作者信息
McSharry C, Vesper S, Wymer L, Howieson S, Chaudhuri R, Wright G R, Thomson N C
机构信息
Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, UK.
National Exposure Research Laboratory, United States Environmental Protection Agency, Cincinnati, OH, USA.
出版信息
Clin Exp Allergy. 2015 May;45(5):902-907. doi: 10.1111/cea.12482.
BACKGROUND
Exposures to indoor biological contaminants have been implicated in asthma's aetiology but their effect on lung function is not well quantified.
OBJECTIVE
The aim of this cross-sectional study of non-smoking, asthmatic adults in Scotland was to determine the correlation between the results from a standard spirometry test, forced expiratory volume in one-second percent (FEV1 %), and quantitative estimates of some biological exposures.
METHODS
A population (n = 55) of non-smoking, adult asthmatics in Scotland was included in this study and each completed a questionnaire that allowed the determination of the Asthma Control Questionnaire scores (ACQ) and St. George's Respiratory Questionnaire scores (SGRQ), as well as corticosteroid use. Spirometry testing was completed and the pre-bronchodilator FEV1 % value calculated. At about the same time, floor dust samples were collected in the living room and in the bedroom. These dust samples were analysed for mould contamination, as described by the Environmental Relative Moldiness Index (ERMI) values and by (1, 3)-β-D-glucan concentrations, for endotoxin, and for dust mite, cat, and dog allergen concentrations. The asthmatics' FEV1 % values were tested for correlation (Pearson) to questionnaire-based estimates of health. Also, each biological exposure was tested for correlation (Pearson) to the FEV1 % values.
RESULTS
FEV1 % results were correlated with ACQ scores (ρ -0.586, P < 0.001), SGRQ scores (ρ -0.313, P = 0.020), and weakly with corticosteroid use (ρ -0.221, P = 0.105). The ERMI values in the homes (average 5.3) were significantly correlated with FEV1 % values (ρ -0.378, P = 0.004). There was no correlation between FEV1 % and concentrations of endotoxin, (1, 3)-β-D-glucan, or any of the allergens.
CONCLUSION AND CLINICAL RELEVANCE
Although these results do not prove that mould exposures caused the deficit in lung function observed in this study, it might be advisable for asthmatics to avoid high ERMI environments.
背景
接触室内生物污染物被认为与哮喘的病因有关，但其对肺功能的影响尚未得到充分量化。
目的
这项针对苏格兰非吸烟哮喘成年人的横断面研究旨在确定标准肺活量测定试验结果、一秒用力呼气容积百分比（FEV1%）与某些生物暴露的定量估计值之间的相关性。
方法
本研究纳入了苏格兰55名非吸烟成年哮喘患者，每人完成一份问卷，用于确定哮喘控制问卷评分（ACQ）、圣乔治呼吸问卷评分（SGRQ）以及皮质类固醇的使用情况。完成肺活量测定试验并计算支气管扩张剂使用前的FEV1%值。大约在同一时间，在客厅和卧室采集地板灰尘样本。按照环境相对霉菌指数（ERMI）值、（1,3）-β-D-葡聚糖浓度、内毒素以及尘螨、猫和狗过敏原浓度对这些灰尘样本进行霉菌污染分析。对哮喘患者的FEV1%值与基于问卷的健康估计值进行相关性（Pearson）测试。此外，对每种生物暴露与FEV1%值进行相关性（Pearson）测试。
结果
FEV1%结果与ACQ评分（ρ -0.586，P < 0.001）、SGRQ评分（ρ -0.313，P = 0.020）相关，与皮质类固醇使用的相关性较弱（ρ -0.221，P = 0.105）。家中的ERMI值（平均5.3）与FEV1%值显著相关（ρ -0.378，P = 0.004）。FEV1%与内毒素、（1,3）-β-D-葡聚糖或任何过敏原的浓度之间无相关性。
结论及临床意义
尽管这些结果并未证明接触霉菌导致了本研究中观察到的肺功能缺陷，但哮喘患者避免高ERMI环境可能是明智的。
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