Low sputum eosinophils predict the lack of response to beclomethasone in symptomatic asthmatic patients
Low sputum eosinophils predict the lack of response to beclomethasone in symptomatic asthmatic patients
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DOI：
10.1378/chest.129.3.565
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发表时间：
2006-03-01
期刊：
影响因子：
9.6
通讯作者：
Paggiaro, P
中科院分区：
文献类型：
--
作者：
Bacci, E;Cianchetti, S;Paggiaro, P
背景资料：低痰嗜酸性粒细胞在类固醇初治的症状性哮喘patients.Aim的预后作用是有争议的：为了验证是否低痰嗜酸性粒细胞预测治疗反应不良吸入皮质类固醇。方法：67例中度哮喘症状性哮喘患者进行了检查前和治疗后2周和4周的丙酸倍氯米松，500吉格bid。在研究前3个月内没有人接受皮质类固醇。在每次访视时，所有患者均接受肺功能测定、乙酰甲胆碱激发和痰诱导。记录患者的症状评分和呼气峰流速（PEF）在整个study.Results：17例患者有低痰嗜酸性粒细胞，尽管有症状。基线痰嗜酸性粒细胞高（> 3%）的患者治疗后症状、肺功能和支气管高反应性显著改善，而痰嗜酸性粒细胞低的患者大多数临床和功能结局无显著改善。在基线检查指标中，痰嗜酸性粒细胞对治疗反应的阴性预测值最高，但阳性预测值较低。多元逐步回归分析显示，只有基线FEV1和痰嗜酸性粒细胞百分比与治疗后FEV1的变化显著相关。结论：我们认为，在检查的指标中，低痰嗜酸性粒细胞是最好的预测激素治疗效果差。
Background: The prognostic role of low sputum eosinophils in steroid-naive, symptomatic asthmatic patients is controversial.Aim: To verify whether low sputum eosinophils predict poor response to treatment with inhaled corticosteroids.Methods: Sixty-seven symptomatic asthmatic patients with moderate asthma were examined before and after 2 weeks and 4 weeks of treatment with beclomethasone dipropionate, 500 jig bid. None received corticosteroids in the 3 months preceding the study. At each visit, all patients underwent spirometry, methacholine challenge, and sputum induction. The patients recorded symptom scores and peak expiratory flow (PEF) throughout the study.Results: Seventeen patients had low sputum eosinophils despite being symptomatic. Patients with high (> 3%) sputum eosinophils at baseline showed significant improvement in symptoms, pulmonary function, and bronchial hyperresponsiveness after treatment, whereas patients with low sputum eosinophils showed no significant improvement in most clinical and functional outcomes. Among the baseline indexes examined, sputum eosinophils bad the highest negative predictive value but low positive predictive value for the response to treatment. Multiple stepwise regression showed that only baseline FEV1 and sputum eosinophil percentages significantly correlated with changes in FEV1 after treatment.Conclusions: We suggest that, among the indexes examined, low sputum eosinophils are the best predictor for poor corticosteroid effects in asthma.