非急性发作期混合粒细胞型哮喘临床特征分析  

Analysis of clinical features of mixed granulocytic asthma in non-acute episode phase

作　　者：肖冠华[1] 刘来昱[1] 梁振宇[1] 赵海金[1] 蔡绍曦[1] 

机构地区：[1]南方医科大学南方医院呼吸与危重症医学科慢性气道疾病实验室,广州510515

出　　处：《国际呼吸杂志》2016年第7期504-507,共4页International Journal of Respiration

基　　金：国家自然科学基金（81270087、81270089、81300029、81470228）;广东省自然科学基金（2015A030310497）;广东省科技计划项目（20128091100153）

摘　　要：目的探讨混合粒细胞型（Mix型）哮喘的临床特征。方法回顾性收集南方医科大学南方医院呼吸科门诊自2012年3月至2014年2月非急性发作期的哮喘患者134例（排除呼吸道感染和其他肺部疾病）。人选患者填写一般人口学资料、哮喘控制问卷（asthmacontrolquestionnaire，ACQ5），并收集当日肺功能检查结果以及痰标本、行痰粒细胞分类计数。将痰嗜酸粒细胞计数≥3％且中性粒细胞计数≥64％者定义为Mix型哮喘，其他病例定义为非Mix型。比较Mix型与非Mix型哮喘患者的临床特征。结果Mix型哮喘患者在FEV1、FEV1％、PEF、痰巨噬细胞计数均显著低于非Mix型哮喘患者[分别为（1．77±0．65）LVS（2．26±0．86）L，（63．50±20．79）％vs（74．69±23．95）％，（4．13±1．70）L／sVS（5．35±2．18）L／s，7．50（4．88～13．88）％VS2900（14．13～47．00）％]，差异有统计学意义（t=2．507、2．045、2．478，U=412．50，P值分别为0．013、0．043、0．014、0．000）。Mix型哮喘患者ACQ-5评分显著高于非Mix哮喘患者（2．54±1．43VS1．84±1．11），差异有统计学意义（t=-2．530，P=0．013）。结论Mix型哮喘是一类病情较重的哮喘亚型，伴有更低的肺功能和更少的气道巨噬细胞数目。Objective To analyze the clinical features of mixed granulocytic asthma in non-acute episode phase. Methods We retrospectively reviewed 134 cases of asthma outpatients in non acute episode phase seen in the Nanfang hospital from March 2012 to February 2014, to the exclusion of other lung diseases including airway infections. The clinical data of these patientsr cases were collected using our hospital computerized medical records database, which included the demographic data, asthma control questionnaire （ACQ5） and pulmonary function tests （PFT）. Sputum and venous blood of these patients were also collected and analyzed for cell differential. We divided the 134 cases into the Mix granulocytic asthma group and the non-Mix granulocytic asthma group depending on their the sputum eosinophils 3 % and the neutrophils≥64 %. We compared the clinical characteristics and survey the difference between the two groups. Results Compared to the non-Mix granulocytic asthma group, a significant decrease in the first second forced vital capacity （FEV1） [-（1.77±0.65） L vs （2.26±0.86） L, t=2.507, P=0.013],FEV1 asFEV1%（63.50±20.79）% vs （74.69±23.96）%,（t =2.045, P=0.043）,PEF（4.13± 1.70） L/s and （5.36±2.18） L/s, （t =2.478, P =0.014）,the count of sputum macrophage 7.50 （4.88±13.88）% and 29.00（14.13±47.00）%,（U =412.50, P =0.000） and the scores of ACQ-5（2.54±1.43 vs 1.84% 1.11, t = --2. 530, P = 0. 013） was significantly higher in the Mix granulocytic asthma group. Conclusions We found that the mixed granulocytic asthma was more severe among the asthma outpatients with lower FEV1% and the decrease of number of sputum macrophage.

关 键 词：哮喘 混合粒细胞型哮喘 诱导痰 炎症表型 

分 类 号：R562.25[医药卫生—呼吸系统]