哮喘患者痰液中亚硝酸盐/硝酸盐含量的变化及其意义  

The changes of NO 2/NO 3 level in sputum from patients with asthma and their clinical implications

作　　者：王瑜[1] 王辰[1] 童朝晖[1] 庞宝森[1] 马力[1] 李氢元[1] 

机构地区：[1]首都医科大学附属北京红十字朝阳医院呼吸疾病医疗研究中心,100020

出　　处：《中华结核和呼吸杂志》1999年第8期453-456,共4页Chinese Journal of Tuberculosis and Respiratory Diseases

摘　　要：目的　探讨痰液中一氧化氮（ Ｎ Ｏ） 代谢终产物———亚硝酸盐／ 硝酸盐（ Ｎ Ｏ２／ Ｎ Ｏ３） 测定在哮喘临床中的应用价值。方法　应用 Ｇｒｉｅｓｓ 重氮法测定４５ 例不同时期、不同程度哮喘患者及１５ 例慢性支气管炎（ 慢支） 合并肺心病急性发作期患者痰液、血清 Ｎ Ｏ２／ Ｎ Ｏ３ 含量，同步测定哮喘患者痰液中嗜酸细胞阳离子蛋白（ Ｅ Ｃ Ｐ） 水平及肺通气功能。结果　哮喘轻、中、重度发作期患者痰液 Ｎ Ｏ２／ Ｎ Ｏ３ 中位数浓度（ 分别为１３１ μｍｏｌ／ Ｌ、１３６ μｍｏｌ／ Ｌ） 与缓解期组（８５ μｍｏｌ／ Ｌ） 及正常对照组（６３ μｍｏｌ／ Ｌ） 比较，差异有显著性（ Ｐ＜ ００５） ；发作期组与缓解期组比较差异有显著性（ Ｐ＜ ０ ．０５） ；慢支合并肺心病急性发作期患者痰液 Ｎ Ｏ２／ Ｎ Ｏ３ 水平（３３ μｍｏｌ／ Ｌ） 与各哮喘组及正常对照组比较，差异有显著性（ Ｐ＜ ００５） 。缓解期及发作期哮喘患者痰液 Ｎ Ｏ２／ Ｎ Ｏ３ 与一秒钟用力呼气容积占预计值百分比（ Ｆ Ｅ Ｖ１ 占预计值％ ）间呈显著负相关（ｒ 分别＝ － ０５８７ 、－ ０４８５ ， Ｐ 均＜ ００５） ；而痰液 Ｎ Ｏ２／ Ｎ Ｏ３ 与 Ｅ Ｃ ＰObjective To evaluate the clinical applications of the detection of the stable end products of NO, nitrite and nitrate (NO 2/NO 3) in sputum from patients with asthma. Methods 45 patients with asthma at remission (groupⅠ, n =15) or exacerbation state with mild attack (groupⅡ, n =15) or moderate to severe attack (groupⅢ, n =15) , 15 cases of chronic cor pulmonale secondary to chronic bronchitis at exacerbation (groupⅣ), and 20, normal control subjects (groupⅤ n =20) were included in this study. NO 2/NO 3 in sputum and serum were measured by Griess reaction , while the eosinophil cationic protein (ECP) in sputum and pulmonary function were also measured in tested patients with asthma. Results The median concentrations of sputum NO 2/NO 3 in groupⅠ, Ⅱand Ⅲwere 85, 131 and 136 μmol/L respectively , all were significantly higher than that in controls (63 μmol/L); those of groupⅡ and Ⅲ were significantly higher than that of groupⅠ, while that of group Ⅳ (33 μmol/L) was significantly lower than those of the asthmatic groups and the control. The level of NO derivatives in sputum was closely correlated with the degree of airflow obstruction and sputum ECP levels in patients with asthma at remission ( r =-0 587, P <0 05; r =0 535, P <0 01 respectively) and exacerbation ( r =-0 485, P <0 05; r =0 563, P <0 05 respectively). There was no significant correlation between serum and sputum NO 2/NO 3 , and no significant correlation between serum NO 2/NO 3 and the degree of airflow obstruction. A significant decrease in the concentration of sputum NO 2/NO 3 was observed after therapeutic treatment of patients with moderate to severe attack (136 vs 93 μmol/L). Conclusion The level of NO 2/NO 3 in sputum may be a useful marker for monitor

关 键 词：哮喘 痰 一氧化氮 ECP 亚硝酸盐 

分 类 号：R562.25[医药卫生—呼吸系统]