ObjectiveTo explore the relationship of obesity with asthma control and airway inflammatory phenotype. MethodsA cross-sectional prospective study was conducted on 101 patients with asthma. Asthma control level was assessed by Asthma Control Test (ACT) and GINA. Furthermore, height and weight were measured and body mass index (BMI) was calculated. Lung function and sputum induction were performed, and differential cell count was obtained from induced sputum and peripheral blood. ResultsNinety eligible patients were divided into 3 groups as a normal-weight group (n=54), an over-weight group (n=21) and an obesity group (n=15). The asthma control levels were different among three groups (P=0.019 for ACT and P=0.014 for GINA, respectively). BMI was positively related to the number of neutrophils in induced sputum (r=0.29, P=0.039). Increased BMI deteriorated asthma control levels assessed by ACT[OR=1.84, 95% CI (1.04, 3.23), P=0.035] and GINA[OR=2.27, 95% CI (1.27, 4.07), P=0.006] in a dose-response manner. Obesity indicated poor asthma control assessed by ACT (P=0.015) and GINA (P=0.008) after adjusting for age, sex, duration of asthma, FEV1%pred, smoking, and the number of neutrophils in peripheral blood. ConclusionsIn Chinese individuals with asthma, neutrophilic inflammatory phenotype dominates the airway inflammation of obesity-associated asthma. Obesity is a risk factor that deteriorates asthma control level in a significant dose-response manner.
ObjectiveTo evaluate the effects of home mechanical ventilation (HMV) for stable chronic obstructive pulmonary disease (COPD) patients with respiratory failure in Tongzhou district of Beijing city. MethodsTwenty stable COPD patients with respiratory failure were included in the study.During the one-year follow-up period,4 patients died and 1 withdrew and 15 patients finished the follow-up.The patients was followed up by telephone each month and guided in drug administration,HMV,and rehabilitation therapy.At the beginning of the study and one year later,the patients were interviewed and accessed on the general data,nutritional status,COPD assessment test (CAT),Borg dyspnea and respiratory fatigue score,Hamilton depression scale,Hamilton anxiety scale,and arterial blood gas analysis. ResultsAt the end of one-year follow-up,nutrition index,CAT,Borg dyspnea and respiratory fatigue score,Hamilton depression scale,Hamilton anxiety scale,pH,and PaO2 did not change significantly (P>0.05),while PaCO2 decreased significantly compared with those at the beginning of the study (P<0.05).Compared with the past year,the times of hospitalization due to acute exacerbation of COPD was significantly reduced during the follow-up year (P<0.05). ConclusionHMV can ameliorate carbon dioxide retention and reduce times of hospitalization due to acute exacerbation of COPD for COPD patients with respiratory failure.