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目的探讨哮喘患者诱导痰中嗜酸性粒细胞(Eos)和嗜酸细胞阳离子蛋白(ECP)与其哮喘严重程度的关系及鉴别诊断价值。方法选择武汉大学人民医院2002-07~2004-06的门诊哮喘患者59例,检测其肺功能并分别采用瑞氏染色及荧光免疫法检测高渗盐水诱导痰中Eos数量和ECP质量浓度。选择同期20例慢性阻塞性肺疾病患者和10名健康人作为对照。结果哮喘患者诱导痰中Eos数量与患者第1秒用力呼气容积/用力肺活量(FEV1%)呈显著负相关(r=-0·65,P<0·01);ECP质量浓度与患者FEV1%呈显著负相关(r=-0·59,P<0·01)。随病情加重哮喘患者诱导痰中Eos数量和ECP质量浓度逐渐升高,且轻度、中度和重度患者之间比较差异有统计学意义(P<0·05)。哮喘患者诱导痰中Eos数量和ECP质量浓度显著高于慢性阻塞性肺疾病组和健康组(P<0·01)。结论诱导痰中Eos和ECP质量浓度可了解哮喘的严重程度,并有助于与慢性阻塞性肺疾病的鉴别。
Objective To investigate the relationship between sputum eosinophils (Eos) and eosinophil cationic protein (ECP) and the severity of asthma in asthmatic patients and their differential diagnostic value. Methods Fifty-nine outpatients with asthma were selected from People’s Hospital of Wuhan University from July 2002 to June 2004, their lung function was measured and the amount of Eos and the concentration of ECP in sputum were detected by Wright staining and fluorescence immunoassay. Twenty patients with chronic obstructive pulmonary disease and 10 healthy people were selected as controls. Results The number of Eos in induced sputum of asthmatic patients was significantly and negatively correlated with FEV 1% (r = -0.65, P <0.01). The correlation between ECP concentration and FEV 1% There was a significant negative correlation (r = -0.59, P <0.01). With the aggravation of asthma patients induced sputum Eos number and ECP mass concentration gradually increased, and mild, moderate and severe patients was statistically significant (P <0.05). The number of sputum Eos and the mass concentration of ECP in asthmatic patients were significantly higher than those in chronic obstructive pulmonary disease group and healthy group (P <0.01). Conclusion Induced sputum Eos and ECP mass concentration can understand the severity of asthma and contribute to the identification of chronic obstructive pulmonary disease.