Observation On The Influence Of Severe Haze On Patients With Bronchial Asthma

Objectives The subjects were selected from bronchial asthma patients in Tangshan city and to further explored the impact of haze exposure on acute exacerbation,FeNO,pulmonary function(PEF%,FEV1%)IL-13 and IL-17 in different months,and the impact on ACT score,asthma control level and severity of asthma through 4 months follow-up.Methods A total of 160 adult bronchial asthma patients(age greater than 17 years old)were collected from March 2016 to October 2016 in our hospital.All the patients were in chronic duration(intermittent state).The course was between 3-5 years and the condition was well controlled.According to the changes in clinical symptoms and sternum and blood routine,20 patients with infection were excluded,and 140 subjects were finally completed.There were 65 male patients and 75 female patients.Home heating is a unified heating.All subjects were followed up to the Department of respiration outpatient of our hospital in two days before and after the end of the November 2016 to February 2017 and the following indicators were tested in our department of respiration,including: lung CT,pulmonary function test(PEF%pred,FEV1%pred),exhaled nitric oxide(FeNO),fasting blood test,serum inflammatory factor interleukin 13,interleukin 17(IL-13,IL-17)and blood routine.At the same time,the subjects completed the asthma test control score(ACT),asthma control level questionnaire,acute attack,haze prevention measures and asthma severity assessment under the guidance of specially trained personnel.and the PM2.5 value of real-time monitoring during the follow-up period was recorded,and the number of PM2.5 exposures at different levels of each month was counted,that is the number of mild haze,moderate haze and severe haze days.The relationship between PM2.5 peak value,monthly mean and severe haze exposure days and acute exacerbation of asthma,pulmonary function(PEF%pred,FEV1%pred),FeNO,serum inflammatory factors(IL-13,IL-17)and ACT were analyzed.SPSS20.0 statistics software was used to analyze and deal with the collected data,and the difference of P<0.05 showed that the results were statistically significant.Results 1 1)The frequency of acute seizures in male and female asthmatic patients exposed to smog was similar and the difference was not statistically significant(P > 0.05).2)The frequency of exacerbation of asthma patients aged >40 years exposed to smog was significantly higher than that of asthma patients <40 years of age.The difference was statistically significant(P < 0.05).2 PM2.5 peak in November,December,January and February were 400ug/m3,488ug/m3,416ug/m3 and 424ug/m3,and the days of severe haze in each month were 7days,13 days,10days,and 5 days.There were differences between the mean values of PM2.5 and PM2.5 in severe haze days in each month,and The differences were statistically significant(P<0.05).3 1)There was a significant difference between the acute attack rate of asthma in November,December,January and February(P<0.05).2)Active smoking,passive smokers and sensitive seasons had a higher incidence of asthma in the exposure of PM2.5 high level,and the results were statistically significant(P<0.05).3)Taking anti haze measures can reduce the acute attack rate of asthma in the exposure of PM2.5 high levela,and the result were statistically significant(P<0.05).4 1)There were a difference between the peak of PM2.5 and the PM2.5 mean and the incidence of acute attack in patients with asthma in different months,and the results were statistically significant(P<0.05).2)There was a positive correlation between the duration of severe PM2.5 and the number of acute episodes,and the results were statistically significant(P<0.05).5 1)There were significant differences in IL-13 and IL-17 levels between asthmatic patients in different months at different PM2.5 exposure levels(P<0.05).2)There were significant differences in FEV1%pred,PEF%pred,FeNO and ACT scores between asthmatic patients in different months at different PM2.5 exposure(P<0.05).6 There were significant differences in the level of asthma control and the severity of the disease in the asthmatic patients at different PM2.5 exposure levels(P<0.05).Conclusions 1 Severe haze can increase the frequency of acute attacks in asthmatic patients,increase the levels of serum inflammatory cytokines IL-13,IL-17,and FeNO,increase airway inflammation,decrease lung function,decrease ACT scores,further increase the difficulty of asthma control,and exacerbate the disease.2 People aged 40 years and over,smoking,seasonal sensitivity can increase the frequency of acute attacks in asthmatic patients under severe haze,and adopting anti-convulsive measures can reduce the frequency of acute asthma attacks.