诱导痰嗜酸粒细胞检测在支气管哮喘-慢性阻塞性肺疾病重叠综合征中的应用  

Detecting eosinophil of induced sputum in asthmatic chronic obstructive pulmonary disease overlap syndrome

作　　者：刘凌云[1] 曾勉[3] 左万里[1] 康丽玫[2] 

机构地区：[1]广东省江门市中心医院呼吸内科,529000 [2]广东省江门市中心医院爱婴区,529000 [3]中山大学第一附属医院呼吸内科,广州510000

出　　处：《国际呼吸杂志》2016年第2期91-94,共4页International Journal of Respiration

摘　　要：目的：本研究旨在探讨哮喘-COPD重叠综合征患者诱导痰嗜酸性粒细胞水平及其与吸入糖皮质激素治疗效果的关系，为哮喘-COPD重叠综合征的诊断及治疗提供依据。方法：选择2012年6月一2014年6月我院诊治的稳定期哮喘-COPD重叠综合征（ACOS）患者60例（ACOS组），同期在我院诊治的无合并哮喘的稳定期COPD患者60例（单纯COPD组）。所有受试者均接受肺功能检查，包括支气管舒张试验，动脉血气分析，血嗜酸性粒细胞计数及诱导痰中炎性细胞的分析。结果：外周血嗜酸性粒细胞计数和诱导痰嗜酸性粒细胞计数ACOS组均显著高于单纯COPD组。ROC曲线分析显示以2.5%为截点，诱导痰嗜酸性粒细胞计数诊断ACOS的敏感性为82.4%，特异性84.8%。吸入糖皮质激素（ICS）治疗后的FEV1值增幅ACOS组亦显著高于单纯COPD组。ACOS组吸入糖皮质激素（ICS）治疗后的FEV1值增幅与诱导痰嗜酸性粒细胞计数显著正相关。 结论：诱导痰嗜酸性粒细胞检测可作为ACOS的诊断指标之一，且能较好的预测ACOS对ICS治疗的反应性。Objective This research aims to investigate the asthma -COPD overlap syndrome induced sputum eosinophil level and its relationship with the treating effects of inhalation of glucocorticoid.. Methods From June 2014 to June 2012, sixty asthma -COPD overlap syndrome （ACOS） patients （group ACOS）, and the same period in our hospital 60 cases of COPD patients without asthma（COPD group） were selected to the research. All subjects underwent pulmonary function tests, including bronchial dilation test, arterial blood gas analysis, analysis of blood eosinophil count and induce inflammatory cells in induced sputum. Results Peripheral blood eosinophil count and eosinophil counts in induced sputum in ACOS group were significantly higher than that of pure COPD group. ROC curve analysis showed that in 2.5% as the cut-off point, the sensitivity of eosinophil count in diagnosis of ACOS in induced sputum was 82.4%, the specificity 84.8%. Inhaled corticosteroids （ICS） after treatment FEV1 value increased in ACOS group were significantly higher than the pure COPD group. ACOS group inhaled corticosteroids （ICS） after treatment of FEV1 was correlated with an increase in induced sputum eosinophil count. Conclusion Eosinophil can be used as one of the diagnostic criteria of ACOS in induced sputum, and can predict ACOS response to ICS therapy.

关 键 词：慢性阻塞性肺疾病 哮喘 哮喘-COPD重叠综合征 吸入糖皮质激素 肺功能 

分 类 号：R563.9[医药卫生—呼吸系统] R562.25[医药卫生—内科学]