哮喘气道中性粒细胞性炎症表型的临床意义  

Clinical significance of neutrophilic airway inflammatory phenotype in patients with asthma

作　　者：刘禹[1] 李志伟[1] 杨旭[1] 刘湘[1] 高瞻[1] 陈华萍[1] 王长征[1] 

机构地区：[1]第三军医大学新桥医院全军呼吸内科研究所,重庆400037

出　　处：《中华肺部疾病杂志（电子版）》2015年第2期28-31,共4页Chinese Journal of Lung Diseases(Electronic Edition)

基　　金：国家自然科学基金(81270075)

摘　　要：目的探讨哮喘中性粒细胞性气道炎症与临床控制的关系,为哮喘临床防治提供指导。方法选择2011年8月至2014年6月在第三军医大学新桥医院呼吸内科门诊就诊的中性粒细胞性哮喘患者40例,采集患者病史、ACT评分、诱导痰和肺功能等检查结果,统计分析诱导痰中性粒细胞百分比、绝对计数与ACT评分、FEV1%pred的相关性。结果在纳入的40例中性粒细胞哮喘患者中,女性26例(65.00%),男性14例,平均年龄(42.70±13.74)岁,发病年龄>12岁31例(77.50%),病程(11.32±12.25)年,ACT(17.15±4.80)分,诱导痰嗜酸粒细胞比例(0.49±0.80)%,诱导痰嗜酸粒细胞计数(0.03±0.06)×106/g,诱导痰中性粒细胞比例(73.79±5.83)%,诱导痰中性粒细胞计数(5.21±2.09)×106/g,FEV1%pred(75.50±21.83)%。在中性粒细胞哮喘组中,诱导痰中性粒细胞百分比、中性粒细胞绝对计数、细胞总数、ACT评分与FEV1%pred存在相关性(P<0.05,r分别为-0.373、-0.530、-0.519、0.552)。结论中性粒细胞性哮喘其临床特征多种多样;哮喘患者气道中性粒细胞性炎症与临床控制存在相关性,提示中性粒细胞炎症可能参与了气道阻塞的发生发展;ACT是一种简易评价哮喘控制水平的工具。Objective To investigate the correlation between neutrophilic airway inflammatory phenotype and clinical control in patients with asthma. To provide guidance for clinical prevention and treatment of asthma. Methods A total of 40 neutrophilic asthma patients were collected from the out-patient departments of respiratory diseases of Xinqiao Hospital of Third Military Medical University between August 2011 and June2014. Patient history,ACT scores and induced sputum and pulmonary function tests were collected and analyzed. It was analyzed that neutrophil percentage of induced sputum,absolute counting and ACT scores,the correlation of FEV1% pred. Results In the 40 neutrophilic asthma cases recruited,26 cases（ 65. 00%） were female,14 cases were male,mean age（ 42. 70 ± 13. 74） years,The age of onset 31 cases（ 77. 50%） were after12 years,asthma duration（ 11. 32 ± 12. 25） years,ACT（ 17. 15 ± 4. 80） scores,the percentage of neutrophil and eosinophil was（ 73. 79 ± 5. 83） % and（ 0. 49 ± 0. 80） % respectively in induced sputum. The conut of neutrophil and eosinophil was（ 5. 21 ± 2. 09） × 106/ g and（ 0. 03 ± 0. 06） × 106/ g respectively in induced sputum. FEV1% perd was（ 75. 50 ± 21. 83） %. There was significantly correlation between neutrophil percentage of the induced sputum or total neutrophil count or the total inflammatory cell count and ACT and FEV1% pred in patients with neutrophilic asthma（ P 〈 0. 05,r is- 0. 373,- 0. 530,- 0. 519,0. 552respectively）. Conclusions The clinical features of neutrophilic asthma are various. There is correlation between neutrophilic airway inflammatory and clinical control in patients with asthma and the neutrophilic airway inflammatory may be involved in the progression and development of airway obstruction in asthma. ACT is simple and easy tool for management of asthma patients.

关 键 词：支气管哮喘 中性粒细胞 炎性表型 诱导痰 临床意义 

分 类 号：R563[医药卫生—呼吸系统]