PT - JOURNAL ARTICLE AU - Shoemark, Amelia AU -坎特，Erin AU -卡雷托，Luis AU - Smith, Alexandria AU - Oriano, Martina AU - Keir, Holly R. AU - Perea, Lidia AU - Canto, elisabeth AU - Terranova, Leonardo AU - Vidal, Silvia AU - Moffitt, Kelly AU - Aliberti, Stefano AU - Sibila, Oriol AU - Chalmers, James D. TI -定点中性粒细胞弹性蛋白酶活性测定鉴别支气管扩张严重程度，呼吸道感染和恶化风险AID - 10.1183/13993003.00303-2019 DP -2019 6月01日TA -欧洲呼吸杂志PG - 1900303 VI - 53 IP - 6 4099 - //www.qdcxjkg.com/content/53/6/1900303.short 4100 - //www.qdcxjkg.com/content/53/6/1900303.full SO - Eur Respir J2019 01月;痰中中性粒细胞弹性蛋白酶活性可识别气道感染高危患者和支气管扩张加重患者。这种生物标志物在临床实践中的应用是有限的，因为没有可用的即时检测。我们测试了一种新型半定量侧流装置(中性粒细胞弹性蛋白酶气道测试棒- NEATstik®)是否可以根据严重程度、气道感染和加重风险对支气管扩张患者进行分层。方法使用NEATstik®检测来自英国和西班牙的124例稳定支气管扩张患者的痰样本，该方法将中性粒细胞弹性蛋白酶浓度从0 (<8µg·mL−1弹性蛋白酶活性)评分至10(最大可检测的中性粒细胞弹性蛋白酶活性)。高中性粒细胞弹性蛋白酶活性被认为是NEATstik®级>6级。记录12个月内疾病的严重程度、痰培养引起的气道感染和病情加重情况。在意大利米兰的50名患者中进行了独立验证。测量和主要结果患者中位年龄69岁，1秒用力呼气量(FEV1)为69%。 High neutrophil elastase activity was associated with worse bronchiectasis severity using the bronchiectasis severity index (p=0.0007) and FEV1 (p=0.02). A high NEATstik® grade was associated with a significant increase in exacerbation frequency, incident rate ratio 2.75 (95% CI 1.63–4.64, p<0.001). The median time to next exacerbation for patients with a NEATstik® grade >6 was 103 days compared to 278 days. The hazard ratio was 2.59 (95% CI 1.71–3.94, p<0.001). Results were confirmed in the independent validation cohort.Conclusions A novel lateral flow device provides assessment of neutrophil elastase activity from sputum in minutes and identifies patients at increasing risk of airway infection and future exacerbations.NEATstik®, a simple point-of-care semi-quantitative neutrophil elastase assay, can identify bronchiectasis patients with airway infection and patients at high risk of exacerbations over the subsequent 12 months http://bit.ly/2HL6OyK