Liao Hua, Yang Zifeng, Yang Chunguang, Tang Yan, Liu Shengming, Guan Wenda, Chen Rongchang
1 First Affiliated Hospital of Jinan University, Guangzhou 510630, China ; 2 State Key Laboratory for Respiratory Disease, Guangzhou Institute of Respiratory Diseases, National Clinical Research Center for Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China.
J Thorac Dis. 2016 Mar;8(3):505-12. doi: 10.21037/jtd.2016.02.76.
The prevalence of viral infection triggering asthma exacerbation and its impact on the symptoms and duration of exacerbation are unclear.
Asthma and healthy control subjects were recruited from the First Affiliated Hospital of Guangzhou Medical University between February 2012 and February 2013. Nasal swabs were collected, and respiratory viruses were detected by polymerase chain reaction (PCR). All patients completed questionnaires and a lung function test. Some were followed up for 4 weeks, and symptom changes were evaluated via asthma diaries.
In total, 70 patients with acute asthma exacerbations were recruited. Among them, 34 patients (48.6%) completed the 4-week follow-up study. Another 65 patients with stable asthma and 134 healthy volunteers were also included in this study. The rate of positive viral detection via PCR in acute asthma exacerbation patients was 34.2% (24/70), which is significantly higher than that of stable asthma (12/65; 18.5%; P=0.038) and normal control patients (18/134; 13.4%; P<0.001). Among the viral-positive subjects, the number of viral copies was significantly higher in acute asthma exacerbation patients [(5.00±4.63) ×10(7) copies/L] (mean ± SD) than those in stable asthma patients [(1.24±1.44) ×10(6) copies/L; P<0.001] or in healthy controls [(1.44±0.44) ×10(6) copies/L; P<0.001], whose viral loads were not significantly different from one another (P=0.774). During the 4-week follow-up period, the cough scores on days 1 and 3 were significantly higher in the viral-positive group than in the viral-negative group (day 1: P=0.016; day 3: P=0.004). However, there were no significant differences between these two groups for other tested symptoms, such as dyspnea and total recovery time (P>0.05).
Respiratory viruses may be involved in acute asthma exacerbations, inducing more prominent and persistent cough symptoms.
病毒感染引发哮喘急性加重的发生率及其对急性加重症状和持续时间的影响尚不清楚。
2012年2月至2013年2月期间，从广州医科大学附属第一医院招募哮喘患者和健康对照者。采集鼻拭子，采用聚合酶链反应（PCR）检测呼吸道病毒。所有患者均完成问卷调查和肺功能测试。部分患者进行了4周的随访，通过哮喘日记评估症状变化。
共招募了70例急性哮喘加重患者。其中，34例患者（48.6%）完成了4周的随访研究。本研究还纳入了另外65例稳定期哮喘患者和134例健康志愿者。急性哮喘加重患者中经PCR检测病毒阳性率为34.2%（24/70），显著高于稳定期哮喘患者（12/65；18.5%；P = 0.038）和正常对照患者（18/134；13.4%；P < 0.001）。在病毒阳性受试者中，急性哮喘加重患者的病毒拷贝数[（5.00±4.63）×10⁷拷贝/升]（均值±标准差）显著高于稳定期哮喘患者[（1.24±1.44）×10⁶拷贝/升；P < 0.001]或健康对照者[（1.44±0.44）×10⁶拷贝/升；P < 0.001]，而后两者的病毒载量彼此之间无显著差异（P = 0.774）。在4周的随访期内，病毒阳性组第1天和第3天的咳嗽评分显著高于病毒阴性组（第1天：P = 0.016；第3天：P = 0.004）。然而，两组在其他测试症状方面，如呼吸困难和总恢复时间，差异无统计学意义（P > 0.05）。
呼吸道病毒可能参与急性哮喘加重，引发更突出和持续的咳嗽症状。
