中性粒细胞性慢性持续期哮喘患者治疗前后外周血和诱导痰中嗜酸性粒细胞阳离子蛋白水平及其临床意义  

Peripheral blood and induced sputum levels of eosinophil cationic protein in patients with chronic persistent neutrophilic asthma before and after treatment and its clinical significance

作　　者：梁联哨 邓静敏[1] 邹小英[1] 陈晓丽[1] 韦旋[1] 龚臣[1] 梁斯巧[1] 陈长荣[1] 

机构地区：[1]广西医科大学第一附属医院呼吸疾病研究所,南宁市530021

出　　处：《广西医学》2016年第3期324-327,共4页Guangxi Medical Journal

基　　金：广西高校科学技术研究项目(YB2014068)

摘　　要：目的观察中性粒细胞性哮喘(NA)慢性持续期患者外周血、痰嗜酸性粒细胞阳离子蛋白(ECP)水平及吸入治疗对其的影响。方法未经过规范化治疗的慢性持续期哮喘患者26例,据诱导痰细胞分类计数结果分为NA组13例及嗜酸性粒细胞哮喘(EA)组13例,均给予吸入布地奈德福莫特罗粉治疗,治疗前及治疗1个月时检测血、痰ECP水平,且检测NA组外周血及痰标本中炎症细胞分类计数及肺功能。结果治疗前及治疗后,两组血、痰ECP水平比较,差异均无统计学意义(P>0.05),治疗1月后两组血、痰ECP水平与治疗前比较,差异也无统计学意义(P>0.05)。治疗后NA组痰中性粒细胞(NEU)百分比、NEU计数较前降低(P<0.05),第1秒用力呼气容积占预计值百分比(FEV1%)、第1秒用力呼气容积占用力肺活量百分比、最大呼气流速占预计值百分比(PEF%)及75%和50%容量时的呼气流速-容量曲线较前上升(P<0.05),但血炎症细胞分类计数无明显变化(P>0.05)。NA组血ECP水平与NEU百分比呈正相关(P<0.05);痰标本的ECP水平与嗜酸性粒细胞百分比呈正相关(P<0.05),痰ECP水平、痰NEU百分比均与FEV1%、PEF%等呈负相关(P<0.05)。结论NA慢性持续期患者外周血及痰上清液中均有ECP表达,且表达水平与EA慢性持续期患者无差异,并与气流受限密切相关;联合吸入治疗初期对NA患者气道中性粒细胞炎症有一定作用,但尚不能降低ECP水平。Objective To observe the peripheral blood and sputum levels of eosinophilic cationic protein （ECP） in the patients with chronic persistent neutrophilic asthma（NA） as well as the effect of inhalation therapy on ECP levels. Methods Twenty-six patients with chronic persistent asthma who were not treated by standard therapy were divided into NA group （n = 13 ） and eosinophilic asthma （EA） group（ n = 13 ） based on the sputum cell counts. Both groups were administered inhaled budesonide/formoterol. Before and after one month of treatment,the peripheral blood and sputum ECP were detected in the two groups. The samples of peripheral blood and sputum were detected for inflammatory cell counts in NA group, and lung function examination was performed as well. Results There was no statistical difference in the blood or sputum level of ECP between two groups before and after treatment（ P 〉 0.05 ）. In each group ,there was no statistical difference between the blood level or sputum level of ECP before and after one month of treatment （ P 〉 0.05 ）. In NA group,the percentage and counts of sputum neutrophil decreased, and the percentage of forced expiratory volume in one second to the predicted value （FEV1% ） , percentage of forced vital capacity in one second to forced vital capacity, percentage of peak expiratory flow rate to the predicted value（ PEF% ） ,and maximal midexpiratory flow curve elevated after treatment（P 〈0.05） ,but no statistical change was observe in inflammatory cell counts of blood （P 〉 0.05）. In NA group, the blood ECP level positively correlated with the percentage of blood neutrophil （P 〈 0.05）,the sputum ECP level positively correlated with the percentage of sputum eosinophile （P 〈 0. 05） ,and either the sputum ECP level or the percentage of blood neutrophil negatively correlated with FEV1% and PEF% （P 〈 0.05）. Conclusion ECP exists in the peripheral blood and supernatant sputum of the patients with chronic persistent NA,and there is no

关 键 词：支气管哮喘 中性粒细胞哮喘 慢性持续期 嗜酸性粒细胞阳离子蛋白 外周血 诱导痰 吸入治疗 布地奈德 福莫特罗 

分 类 号：R562.25[医药卫生—呼吸系统]