Differences in airway inflammation in patients with fixed airflow obstruction due to asthma or chronic obstructive pulmonary disease
Differences in airway inflammation in patients with fixed airflow obstruction due to asthma or chronic obstructive pulmonary disease
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DOI：
10.1164/rccm.200203-183oc
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发表时间：
2003-02-01
影响因子：
24.7
通讯作者：
Papi, A
中科院分区：
文献类型：
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作者：
Fabbri, LM;Romagnoli, M;Papi, A
为了确定固定气流阻塞的患者是否具有不同的病理和功能特征，具体取决于哮喘或慢性阻塞性肺部疾病的病史（COPD），我们表征了46个连续的门诊病人，该门诊病人通过临床病史，肺功能测试，呼气的一硝属性测试，表现出固定气流阻塞氧化物，痰分析，支气管肺泡灌洗，支气管活检和高分辨率计算机断层扫描胸部扫描。具有COPD病史的受试者（n = 27）和具有哮喘病史（n = 19）的受试者具有相似程度的固定气流阻塞（FEV1：56 +/- 2对56 +/- 3％）和AIRWAIL过度反应性（PC20FEV1：2.81 [3.1]与1.17 [3.3]）。具有哮喘史的受试者在外周血，痰，支气管肺泡灌洗和气道粘膜中的嗜酸性粒细胞明显更多。痰液和支气管肺泡灌洗液中的中性粒细胞较少； T细胞的较高CD4+/CD8+比率渗透到气道粘膜中；以及上皮地下膜的较厚的网状层。它们还显着降低了残留体积，更高的扩散能力，较高的一氧化氮，较低的高分辨率计算机断层扫描扫描肺气肿评分以及对支气管扩张剂和类固醇的可逆性更大。总之，尽管固定的气流阻塞相似，但与具有COPD病史的受试者相比，具有哮喘病史的受试者具有不同的特征，应适当识别和治疗。
To determine whether patients with fixed airflow obstruction have distinct pathologic and functional characteristics depending on a history of either asthma or chronic obstructive pulmonary disease (COPD), we characterized 46 consecutive outpatients presenting with fixed airflow obstruction by clinical history, pulmonary function tests, exhaled nitric oxide, sputum analysis, bronchoalveolar lavage, bronchial biopsy, and high-resolution computed tomography chest scans. Subjects with a history of COPD (n = 27) and subjects with a history of asthma (n = 19) had a similar degree of fixed airflow obstruction (FEV1: 56 +/- 2 versus 56 +/- 3% predicted) and airway hyperresponsiveness (PC20FEV1: 2.81 [3.1] versus 1.17 [3.3]). Subjects with a history of asthma had significantly more eosinophils in peripheral blood, sputum, bronchoalveolar lavage, and airway mucosa; fewer neutrophils in sputum and bronchoalveolar lavage fluid; a higher CD4+/CD8+ ratio of T cells infiltrating the airway mucosa; and a thicker reticular layer of the epithelial basement membrane. They also had significantly lower residual volume, higher diffusing capacity, higher exhaled nitric oxide, lower high-resolution computed tomography scan emphysema score, and greater reversibility to bronchodilator and steroids. In conclusion, despite similar fixed airflow obstruction, subjects with a history of asthma have distinct characteristics compared with subjects with a history of COPD and should be properly identified and treated.