老年晚发哮喘缓解期患者气道反应性和诱导痰炎性标志物的测定  

Observation of airway hyperresponsiveness and inflammatory markers in induced sputum in elderly patients with stable late onset asthma during the remission period

作　　者：聂汉祥[1] 杨炯[1] 李长生[1] 赵家亮 

机构地区：[1]武汉大学人民医院呼吸内科,430060 [2]荆州市中医院

出　　处：《中华老年医学杂志》2006年第5期328-331,共4页Chinese Journal of Geriatrics

摘　　要：目的检测缓解期老年晚发哮喘(LOA)患者气道反应性和诱导痰嗜酸细胞、嗜酸细胞阳离子蛋白(ECP)和白介素-5(IL-5)水平,探讨其临床意义。方法选择58例缓解期 LOA 患者,测定其气道反应性,并分别采用瑞氏染色、荧光免疫法和酶联免疫吸附试验检测诱导痰中嗜酸细胞数量、ECP 和 IL-5水平;选择25例急性发作期 LOA 患者和15例健康老年人作为对照。结果 58例缓解期 LOA 患者中,49例(84.5%)支气管激发试验阳性,9例(15.5%)阴性。缓解期 LOA 组诱导痰中嗜酸细胞数量[(9.3±3.1)%]、ECP[(144.2±68.1)μg/L]和 IL-5水平[(20.3±6.3)μg/L]显著低于急性发作期 LOA 组[(21.1±9.8)%、(399.3±172.5)μg/L 和(50.6±10.7)μg/L,P<0.01],但显著高于健康老年组[(1.3±0.7)%、(48.7±21.9)μg/L 和(10.3±3.2)μg/L,P<0.01]。气道反应性增高组患者诱导痰中嗜酸细胞数量[(12.7±3.6)%]、ECP[(171.3±69.8)μg/L]和 IL-5水平[(23.6±8.5)μg/L]显著高于气道反应性正常组[(3.1±1.3)%、(52.7±21.1)μg/L 和(13.7±4.1)μg/L,P<0.01]。结论缓解期 LOA 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 investigate the clinical significance of airway hyperresponsiveness, eosinophil （Eos） percentage, levels of eosinophil cationic protein （ECP） and interleukin-5 （IL-5） in induced sputum in elderly patients with late onset asthma（LOA）during the remission period. Methods Fifty-eight elderly patients with LOA during the remission period were selected. Bronchial challenge test was performed and the percentage of Eos and levels of ECP and IL-5 in induced sputum were measured by Wrights＇ stain, immuno-CAP system and ELISA, respectively. Twenty-five elderly patients with LOA during their exacerbation period and 15 healthy elderly subjects were selected as control. Results In fifty-eight LOA patients during their remission period, 49 cases （84. 5%） showed positive bronchial challenge test and 9cases（15.5 %） negative. The percentage of Eos, levels of ECP and IL-5 [（ 9.3 ± 3. 1 ） %], [（ 144.2± 68. 1 ）μg/L] and [（ 20. 3 ± 6.3） μg/L, in induced sputum in patients with LOA during their remission period were lower than those[ （21.1 ± 9.8）%, （399. 3±172.5）μg/L and[ （50. 655 10. 7） μg/L, respectively]in LOA group during the exacerbation period, and higher than those[（1. 3550.7）%, （48.75：21.9） μg/L and （10.3±3.2）μg/L]in healthy group（all P〈001）. The percentage of Eos, levels of ECP and IL-5 in induced sputum were all higher [（12.7±3.6）%]vs [（3.1±1.3）%]vs[（171. 3 ± 69. 8） μg/L] vs （（52. 7 ± 21.1） μg/L] and [（23. 6±8. 5） μg/L]vs[（13. 7±4. 1） μg/L] （all P〈0.01）in positive group than negative group of bronchial challenge test in LOA patients during remission period. Conclusions Airway hyperresponsiveness and persistent airway inflammation still exist in the LOA patients during the remission period and this may be a helpful guidance for treatment.

关 键 词：哮喘 气道阻力 嗜酸细胞 抗微生物阳离子肽类 痰 老年 

分 类 号：R562.25[医药卫生—呼吸系统]