论文部分内容阅读
目的测定缓解期哮喘患者气道反应性和诱导痰嗜酸性粒细胞比例和嗜酸性粒细胞阳离子蛋白(ECP)质量浓度,探讨其临床意义。方法选取2001年1月至2006年6月武汉大学人民医院呼吸内科门诊缓解期哮喘患者76例,测定其气道反应性,并分别采用瑞氏染色和荧光免疫法检测诱导痰中嗜酸性粒细胞比例和ECP质量浓度。选择同期30例急性发作期哮喘患者和20名健康人作为对照。结果76例缓解期哮喘患者中,65例(85.5%)支气管激发试验阳性,11例(14.5%)支气管激发试验阴性。缓解期哮喘患者诱导痰中嗜酸性粒细胞比例为0.071±0.032,ECP质量浓度为131.5μg/L,显著低于急性发作期哮喘组0.198±0.103和355.3μg/L,P<0.01,但显著高于健康对照组0.013±0.007和48.0μg/L,P<0.01。气道反应性增高组哮喘患者诱导痰中嗜酸性粒细胞比例0.098±0.031和ECP质量浓度143.7μg/L显著高于气道反应性正常组0.026±0.012和41.3μg/L,P<0.01。结论缓解期哮喘患者多数存在气道高反应性且气道炎症持续存在,测定患者气道反应性和诱导痰中炎性标志物有助于指导缓解期治疗。
Objective To determine the airway responsiveness and induced sputum eosinophil ratio and eosinophil cationic protein (ECP) concentration in remission asthmatic patients and to investigate its clinical significance. Methods From January 2001 to June 2006, Wuhan University People’s Hospital Respiratory Medicine outpatient remission of asthma in 76 patients, measured airway responsiveness, and were used Wright’s staining and fluorescence immunoassay to detect sputum eosinophils Proportion and ECP mass concentration. Select the same period 30 cases of acute exacerbation of asthma patients and 20 healthy people as a control. Results Of 76 patients with remission asthma, 65 (85.5%) had bronchial provocation test positive and 11 (14.5%) had bronchial provocation test negative. The percentage of eosinophils induced in asthmatic patients during remission was 0.071 ± 0.032, and the concentration of ECP was 131.5μg / L, which was significantly lower than that of acute episode asthma (0.198 ± 0.103 and 355.3μg / L, P <0.01) In the healthy control group 0.013 ± 0.007 and 48.0μg / L, P <0.01. The percentage of eosinophils in sputum induced by asthmatic patients with increased airway reactivity was 0.098 ± 0.031 and the mass concentration of ECP was 143.7μg / L, which was significantly higher than that in normal airway patients (0.026 ± 0.012 and 41.3μg / L, P <0.01). Conclusion Most patients with remission have airway hyperresponsiveness and airway inflammation persists. Measurement of airway reactivity and induction of inflammatory markers in sputum may be helpful to guide remission therapy.