肺炎支原体感染与支气管哮喘相关性研究.docVIP

支气管哮喘气道炎症和哮喘控制与肺炎支原体感染的相关性研究 周阿旺1 沈华浩1 陈志华1 沈雪艳2 [1]浙江大学医学院附属第二医院 呼吸科，浙江 杭州 310009 [2] 绍兴文理学院附属医院呼吸科 浙江 绍兴 312000 [基金项目] 浙江省自然科学基金项目 (Y2110144) 摘 要 目的：探讨支气管哮喘患者的气道炎症、哮喘控制与肺炎支原体感染的关系。方法：选择支气管哮喘急性发作期患者114例（急性发作期组）和支气管哮喘缓解期患者116例（缓解期组），检测两组肺炎支原体特异免疫球蛋白IgM和IgG，比较支原体感染率情况；同时对比两组中支原体感染与无支原体感染患者间痰嗜酸性粒细胞（EOS）计数、血清总免疫球蛋白E （IgE）、第1秒用力呼气容积占预计值的百分比（FEV1%pred）及哮喘控制测试（ACT）评分；并对支原体感染率与各组支原体感染阳性患者的FEV1%pred、ACT评分、血清总IgE及痰EOS计数进行相关性分析。结果：急性发作期组支原体感染率（41.2%）明显高于缓解期组（22.4%），两组比较差异有统计学意义（P0.01）；两组中支原体感染患者痰EOS计数、血清总IgE均高于无支原体感染患者，而FEV1%pred及ACT评分均低于无支原体感染患者，两者差异有统计学意义（P0.05）。结论：无论哮喘急性发作期还是缓解期，支原体感染都是不可忽视的因素，且相较于慢性缓解期，更多见于哮喘急性发作期。 关键词：肺炎支原体；支气管哮喘；痰嗜酸性粒细胞；IgE；FEV1%pred ；ACT评分 The relationship between Mycoplasma pneumoniae infection and asthma control, and the probable mechanism Abstract: We aimed to explore the relationship between Mycoplasma pneumoniae infection and asthma control, and the probable mechanism. 114 asthmatic patients with acute exacerbation and 116 Patients in Remission Stage, including mycoplasma pneumoniae - IgM and mycoplasma -IgG in the serum, the eosinophilic ( EOS ) ratio in the Sputum, total serum IgE ,FEV1%pred and ACT score.We show that 41.2% of patients with acute exacerbation were infected by mycoplasma infection,obviously higher than that of patients in remission group (22.4 %) ( P 0.01 ) ; Amongy either patients with acute exacerbation or Patients in Remission Stage, the eosinophilic ration and total serum IgE in the Sputum of patients with Mycoplasma pneumoniae infection was significantly higher, compared to patients without. FEV1%pred and ACT score of patients with Mycoplasma pneumoniae infection were significantly lower than that of non-mycoplasma infected patients.Collectively, our results identify the relationship between Mycoplasma infection and asthma control. Mycoplasma might enhanced eosinophils recuitment,resulting in a bad asthma control. Key words: Mycoplasma pneumoniae; bronchial asthma; sputum eosinophil; IgE; ACT scores 支气管哮喘是一种非常常见的