Ma Yanliang, Tian Guizhen, Tang Fei, Yu Bing, Chen Yanwen, Cui Yueli, He Quanying, Gao Zhancheng
1 Department of Respiratory and Critical Care Medicine, Peking University People's Hospital, Beijing 100044, China ; 2 Department of Respiratory and Critical Care Medicine, The 263 Hospital of People's Liberation Army, Beijing 101100, China.
J Thorac Dis. 2015 Apr;7(4):585-90. doi: 10.3978/j.issn.2072-1439.2015.01.04.
Mold sensitivity in asthmatic patients has recently attracted clinical interest; however the links between mold sensitivity and asthma severity in the Chinese population have been poorly characterized. In this study, we assess the relationship between asthma severity and airborne mold sensitivity in a cohort of northern Chinese patients.
Ninety-three non-smoking adult outpatients with asthma completed a questionnaire and underwent skin prick testing with five aeroallergens. For all patients, eosinophil cell counts, total serum IgE (sIgE) levels, and pulmonary function were measured. An asthma severity score was calculated based on the patient's forced expiratory volume in one second (FEV1), number of asthma attacks, number of hospital admissions, and use of inhaled or oral corticosteroids in the past year.
Ninety-three patients were divided into three groups based on the results of their allergy tests: negative results for all tested allergens (group A, n=32); positive reactions to aeroallergens including mold antigens (group B, n=41); and positive reactions to aeroallergens other than molds (group C, n=20). Patients in group B had a lower FEV1 (74.46%±23.09% predicted) compared with group A (85.52%±19.53%, P=0.023). Patients in both group B and C had elevated absolute eosinophil count (AEC) (group A: 3.12%±2.71%, group B: 5.41%±2.85%, group C: 6.1%±4.49%; group A vs. group B, P=0.008; group A vs. group C, P=0.002), and total sIgE values (group A: 117.36±144.90 IU/mL, group B: 195.86±155.87 IU/mL, group C: 253.31±152.41 IU/mL; group A vs. group B, P=0.031; group A vs. group C, P=0.002) compared with patients in group A. Asthma severity scores were higher in patients in group B compared to patients in group C (7 vs. 5.5, P<0.05). Patients allergic to molds were more likely to have severe asthma [odds ratio 3.636, 95% confidence interval (CI): 1.394 to 9.484; for severe versus mild asthma, P<0.05]. There was no association between asthma severity and sensitisation to house mites or weeds.
Mold sensitivity is positively correlated with asthma severity in our cohort of northern Chinese patients.
哮喘患者对霉菌的敏感性最近引起了临床关注；然而，中国人群中霉菌敏感性与哮喘严重程度之间的联系尚未得到充分描述。在本研究中，我们评估了一组中国北方患者中哮喘严重程度与空气中霉菌敏感性之间的关系。
93名不吸烟的成年哮喘门诊患者完成了一份问卷，并接受了5种空气过敏原的皮肤点刺试验。对所有患者测量了嗜酸性粒细胞计数、血清总IgE（sIgE）水平和肺功能。根据患者的一秒用力呼气量（FEV1）、哮喘发作次数、住院次数以及过去一年中吸入或口服糖皮质激素的使用情况计算哮喘严重程度评分。
根据过敏试验结果，93名患者被分为三组：所有测试过敏原均为阴性结果（A组，n = 32）；对包括霉菌抗原在内的空气过敏原呈阳性反应（B组，n = 41）；对除霉菌外的空气过敏原呈阳性反应（C组，n = 20）。与A组（85.52%±19.53%，P = 0.023）相比，B组患者的FEV1较低（预测值为74.46%±23.09%）。B组和C组患者的绝对嗜酸性粒细胞计数（AEC）均升高（A组：3.12%±2.71%，B组：5.41%±2.85%，C组：6.1%±4.49%；A组与B组相比，P = 0.008；A组与C组相比，P = 0.002），且总sIgE值也高于A组患者（A组：117.36±144.90 IU/mL，B组：195.86±155.87 IU/mL，C组：253.31±152.41 IU/mL；A组与B组相比，P = 0.031；A组与C组相比，P = 0.002）。B组患者的哮喘严重程度评分高于C组患者（7分对5.5分，P<0.05）。对霉菌过敏的患者更有可能患有重度哮喘[比值比3.636，95%置信区间（CI）：1.394至9.484；重度哮喘与轻度哮喘相比，P<0.05]。哮喘严重程度与对屋尘螨或杂草的致敏之间无关联。
在我们的中国北方患者队列中，霉菌敏感性与哮喘严重程度呈正相关。
