Ojanguren I, Cruz M J, Villar A, Sanchez-Ortiz M, Morell F, Munoz X
Servicio de Neumología, Departamento de Medicina, Hospital Universitario Vall d´Hebron, Universidad Autónoma de Barcelona, Catalonia, Spain.
CIBER Enfermedades Respiratorias (Ciberes), Barcelona, Spain.
BMC Pulm Med. 2015 Sep 30;15:109. doi: 10.1186/s12890-015-0100-5.
The aim of this study was to investigate the influence of the specific inhalation challenge (SIC) on changes of pH values in exhaled breath condensate (EBC) in patients with hypersensitivity pneumonitis (HP).
A prospective study of 85 patients with suspected HP, of whom 63 were diagnosed with HP due to exposure to avian or fungal antigens. In all cases, EBC samples were collected before and after completion of the SIC and pH values were determined.
Taken as a whole, patients with HP did not present changes in EBC pH after SIC. However, considering only patients with exposure to molds, those diagnosed with HP had a significantly more acid pH post-SIC than those with another diagnosis (p = 0.011). This fact is not observed in patients exposed to bird's antigens. A ROC curve showed that a reduction in EBC pH of 0.3 units or more after SIC in patients diagnosed with HP due to exposure to molds had a sensitivity of 30 % (CI: 12.8 to 54.3 %) and a specificity of 100 % (CI: 65.5 to 100 %).
EBC pH may be useful in interpreting SIC results in patients with HP, especially in those patients exposed to molds. Further studies are now required to test the validity of these proposals.
本研究旨在调查特异性吸入激发试验（SIC）对过敏性肺炎（HP）患者呼出气冷凝液（EBC）pH值变化的影响。
对85例疑似HP患者进行前瞻性研究，其中63例因接触禽类或真菌抗原而被诊断为HP。在所有病例中，在SIC完成前后收集EBC样本并测定pH值。
总体而言，HP患者在SIC后EBC的pH值没有变化。然而，仅考虑接触霉菌的患者，诊断为HP的患者在SIC后的pH值明显比其他诊断的患者更酸（p = 0.011）。在接触鸟类抗原的患者中未观察到这一现象。一条ROC曲线显示，因接触霉菌而被诊断为HP的患者在SIC后EBC的pH值降低0.3个单位或更多，其敏感性为30%（95%置信区间：12.8%至54.3%），特异性为100%（95%置信区间：65.5%至100%）。
EBC的pH值可能有助于解释HP患者的SIC结果，尤其是在那些接触霉菌的患者中。现在需要进一步的研究来检验这些提议的有效性。
