Asano Takamitsu, Ohbayashi Hiroyuki, Ariga Mitsue, Furuta Osamu, Kudo Sahori, Ono Junya, Izuhara Kenji
Dept of Allergy and Respiratory Medicine, Tohno Chuo Clinic, Gifu, Japan.
The Shino-Test Corporation, Sagamihara, Japan.
ERJ Open Res. 2020 Jul 20;6(2). doi: 10.1183/23120541.00347-2019. eCollection 2020 Apr.
Dynamic hyperinflation (DH) is sometimes observed and is associated with impaired daily life activities of asthma. We assessed the relationship between DH and asthma biomarkers (blood eosinophil, fractional exhaled nitric oxide ( ) and serum periostin) in patients with asthma.
Fifty patients with stable asthma were prospectively recruited and underwent blood test, measurement, spirometry and metronome-paced tachypnoea (MPT) test to assess DH. In MPT tests, inspiratory capacity (IC) was measured at baseline and after 30 s of MPT with breathing frequencies of 20, 30 and 40 breaths·min. DH was assessed by the decline of IC from baseline, and maximal IC reduction ≥10% was considered as positive DH.
Thirty patients (60%) showed positive DH. Patients with positive DH showed higher serum periostin levels (107.0±30.7 ng·mL) than patients with negative DH (89.7±23.7) (p=0.04). Patients in Global Initiative for Asthma treatment steps 4-5 (n=19) showed higher serum periostin levels (p=0.01) and more severe IC reduction after MPT (p<0.0001) than patients in steps 1-3 (n=31). Maximal IC reduction after MPT was significantly correlated with asthma control test score (r=-0.28, p=0.05), forced expiratory volume in 1 s (r=-0.56, p<0.0001), and serum periostin levels (r=0.41, p=0.003).
Serum periostin may have the possibility to reflect DH in patients with stable asthma.
动态肺过度充气(DH)有时会被观察到,并且与哮喘患者的日常生活活动受损有关。我们评估了哮喘患者中DH与哮喘生物标志物(血液嗜酸性粒细胞、呼出一氧化氮分数( )和血清骨膜蛋白)之间的关系。
前瞻性招募了50例稳定期哮喘患者,进行血液检测、 测量、肺功能测定和节拍器控制的快速呼吸(MPT)试验以评估DH。在MPT试验中,在基线时以及在呼吸频率为20、30和40次·分钟的MPT 30秒后测量吸气容量(IC)。通过IC相对于基线的下降来评估DH,最大IC降低≥10%被视为阳性DH。
30例患者(60%)显示阳性DH。阳性DH患者的血清骨膜蛋白水平(107.0±30.7 ng·mL)高于阴性DH患者(89.7±23.7)(p = 0.04)。全球哮喘防治创议治疗步骤4 - 5的患者(n = 19)比步骤1 - 3的患者(n = 31)显示出更高的血清骨膜蛋白水平(p = 0.01)以及MPT后更严重的IC降低(p < 0.0001)。MPT后最大IC降低与哮喘控制测试评分(r = -0.28,p = 0.05)、第1秒用力呼气量(r = -0.56,p < 0.0001)和血清骨膜蛋白水平(r = 0.41,p = 0.003)显著相关。
血清骨膜蛋白可能有可能反映稳定期哮喘患者的DH。