ABSTRACT
Objective To investigate the effect of inhaled corticosteroid (ICS) on lung function and inflammatory mediators in cough variant asthma (CAV).Methods Fifty patients with CVA were randomly divided into group A (n =30) and group B (n =20),and 20 normal cases were recruited as healthy group (group C) in this study.All the cases were given a lung function test,bronchial dilation test(BDT) and serum levels of inflammatory mediators(interleukin(IL)-5,IL-8 and IL-10) assessment.The cases in group A were given longterm ICS intervention therapy of inhaled budesonide aerosol at dose of 200 μg/day with 6 months' follow-up period.The cases in group B and C were given salbutamol and symptomatic treatment if necessary.Assessment about lung function (forced vital capacity (FVC),1 s forced expiratory volume (FEV1),peak expiratory rate (PER) and maximum mid-expiratory flow rate(MMEF)),BDT,and inflammatory mediators in all groups were performed before and after treatment.Results (1) Lung function:before treatment,the level of FVC,FEV1 and PEF in three groups were not significantly different (P ＞ 0.05).MMEF in group A and B is significantly lower than that in group C (F =58.40,P ＜ 0.05).In group A,MMEF was significantly improved (P ＜ 0.05,P ＜ 0.01) after 3 and 6 months ICS treatment.In group B,MMEF was not statistical improvement compared with before treatment(P ＞0.05).The BDT positive rate in group C was significantly lower than that in group A and B.The BDT positive rate in group A decreased after ICS treatment for 3 and 6 months.Meanwhile,the BDT level decreased as the longer treatment.In group B,there was no statistical decrease in terms of BDT positive rate(P ＞0.05).(2)Inflammatory mediators:in group C,the serum levels of IL-5 and IL-8 were lower than those in group A and B,but the level of I L-10 was higher than it in the other two groups(P ＜0.05).After 3 and 6 months ICS treatment,the serum levels of IL-5 and IL-8 were significantly decreased and the level of I L-10 was increased.The longer course was given,the more obvious change they have.There was no statistical difference in group B after 3 to 6 months treatment.It was statistical difference between group A and group B after 3 to 6 months treatment (P ＜ 0.05).Conclusion ICS treatment can significantly improve lung function and inflammatory mediators in patients with cough variant asthma.The better improvement will get if the longer treatment is given.
ABSTRACT
Objective To analyse the airway reversibility and variability for bronchial asthmatic patients .Methods The status of test positive ratio and combined airflow limitation were analysis for 650 Clinical diagnosed asthmatic patients .527 cases were given bronchial dilation test and 123 cases were given provocative test .Results Positive ratio of 527 cases bronchial dilation test was 41 . 4% .Positive ratio of 123 cases provocative test was 52 .0% .The airflow limitation(FEV1/FVC% <70% ) ratio of total 650 cases was 34 .0% .In the 193 cases of combined airflow limitation patients which was given bronchial dilation test ,the positive ratio of bronchial dilation test was 61 .7% .Conclusion Bronchial dilation test need repeat because of its less sensitivity .The positive ratio of provocative test is not high ,so the patients of provocative test negative couldn′t exclude the diagnosis of asthma .The ratio of bronchial dilation test was high for combined airflow limitation asthmatic patients .Its may clew that the patients combined airflow limitation may be exacerbation and need actively therapy .