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【目的】寻找临床上简便易行、可靠的早期诊断吸烟致气道炎症的方法。【方法】检测了51例健康吸烟者支气管肺泡灌洗液(BALF),并以BALF中细胞计数绝对值将炎症程度分为Ⅰ,Ⅱ,Ⅲ度;同时进行乙酰甲胆碱(Mch)支气管激发试验与24h最大呼气流量(PEF)测定。【结果】①51例检测对象BALF细胞计数绝对值为(2.3~47.2)×108/L,其炎症分度为Ⅰ度16例,Ⅱ度22例,Ⅲ度13例。②Mch支气管激发试验阳性率64.7%(Ⅰ度50%,Ⅱ度68.2%,Ⅲ度76.9%)。③24h-PEF变异值异常率62.7%(Ⅰ度37.5%,Ⅱ度72.7%,Ⅲ度76.7%),以上结果与BALF炎症程度的相关性较好。【结论】本文方法可较好地反映吸烟致气道炎症的严重程度,Mch支气管激发试验与PEF测定可作为吸烟气道炎症早期诊断的无创性指标之一。
【Objective】 To find a clinically simple, reliable and early diagnosis of airway inflammation caused by smoking. 【Methods】 Bronchoalveolar lavage fluid (BALF) was detected in 51 healthy smokers and the degree of inflammation was divided into Ⅰ, Ⅱ and Ⅲ degrees according to the absolute value of cell count in BALF. Simultaneous methacholine (Mch) bronchial provocation Test and 24h maximum expiratory flow (PEF) determination. 【Results】 ① The absolute value of BALF count in the 51 subjects was (2.3 ~ 47.2) × 108 / L, the degree of inflammation was 16 grade Ⅰ, 22 grade Ⅱ and 13 grade Ⅲ. ② Mch bronchial provocation test positive rate was 64.7% (Ⅰ degree 50%, Ⅱ degree 68.2%, Ⅲ degree 76.9%). ③ The abnormality rate of24h-PEF was 62.7% (Ⅰ 37.5%, Ⅱ.72.7%, Ⅲ76.7%). The correlation between the above results and the degree of inflammation of BALF was better. 【Conclusion】 The present method can better reflect the severity of airway inflammation caused by smoking. Mch bronchial provocation test and PEF determination can be used as one of the noninvasive indicators for the early diagnosis of smoking airway inflammation.