诱导痰细胞分类在嗜酸细胞性支气管炎诊断和治疗中的应用  

Effect of induced sputum on diagnosis and treatment of eosinophilic bronchitis

作　　者：王斌 胡明冬 徐静 张椿 陈华萍 王关嵩 徐智 李琦 Wang Bin;Hu Mingdong;Xu Jing;Zhang Chun;Chen Huaping;Wang Guansong;Xu Zhi;Li Qi(Institute of Respiratory Diseases, Xinqiao Hospital, Army Medical University, Chongqing 400037, China;Department of Gerontology and Secret Service Medicine, Xinqiao Hospital, Army Medical University, Chongqing 400037, China;Medical Department, Xinqiao Hospital, Army Medical University, Chongqing 400037, China)

机构地区：[1]陆军(第三)军医大学第二附属医院全军呼吸内科研究所,重庆400037 [2]陆军(第三)军医大学第二附属医院老年与特勤医学科,重庆400037 [3]陆军(第三)军医大学第二附属医院医务处,重庆400037

出　　处：《中华肺部疾病杂志（电子版）》2020年第4期466-469,共4页Chinese Journal of Lung Diseases(Electronic Edition)

基　　金：国家重点研发计划(2017YFC0112702);陆军军事医学创新工程(18CXZ002);陆军军医大学第二附属医院临床科研重点项目(2016YLC06)。

摘　　要：目的探索诱导痰细胞分类在嗜酸细胞性支气管炎(EB)诊断和治疗中的作用。方法回顾性分析我院门诊239例慢性咳嗽患者,依据慢性咳嗽中诊断标准,分为非EB组和EB组,分析两组诱导痰中细胞分类情况;同时给予EB患者进行8周治疗,观察经治疗后诱导痰中各细胞分类的改变情况。结果239例慢性咳嗽患者中,非EB患者216例,占90.7%,EB患者23例,占9.3%,两组中共有121例(50.6%)患者诱导痰中嗜酸细胞百分比升高;非EB患者组细胞总计数为(4.83±2.61)×10^6个/g、嗜酸细胞比例为(4.56±10.07)%、中性粒细胞比例为(50.32±26.12)%、淋巴细胞比例为(5.14±7.27)%、单核巨噬细胞比例为(40.30±16.70)%,EB患者组痰中细胞总计数为(5.46±3.07)×10^6个/g、嗜酸细胞比例为(13.85±12.23)、中性粒细胞比例为(46.16±16.89)、淋巴细胞比例为(4.83±2.98)、单核巨噬细胞比例为(35.91±16.35),两组间EB组嗜酸细胞比例有显著的增多(P<0.05),在性别、年龄以及其余细胞成分差异无统计学意义(P>0.05);EB患者组经治疗后,痰中细胞总计数为(4.07±3.89)×10^6个/g、嗜酸细胞比例为(2.52±3.80)%、中性粒细胞比例为(54.18±17.97)%、淋巴细胞比例为(5.59±4.33)%、单核巨噬细胞比例为(38.32±17.23)%,嗜酸细胞较治疗前有显著减少(P<0.05),其余细胞改变无显著差异(P>0.05)。结论诱导痰细胞分类检查是诊断EB的重要方法,在其诊断和治疗过程中有着重要的指导作用,可作为EB治疗过程的监测指标。Objective To explore the effect of induced sputum on the diagnosis and treatment of eosinophilic bronchitis(EB).Methods A total of 239 outpatients with chronic cough in our hospital were divided into an EB group and a non-EB group according to the diagnosis standard of EB.The cells in the induced sputum were analyzed for all the patients.Then the patients in the EB group were treated for 8 weeks,and the changes of the induced sputum were detected after treatment.Results Among the 239 patients with chronic cough,216(90.7%)were non-EB patients and 23(9.3%)were EB patients.The percentage of eosinophils increased in the induced sputum of 121(50.6%)patients in the two groups.The total cell count of non-EB patients was(4.83±2.61)×10^6 cells/g,the proportion of eosinophils accounted for(4.56±10.07)%,and the proportion of neutrophils accounted for(50.32±26.12)%.The percentages of lymphocytes and monocyte-macrophages in the sputum accounted for(5.14±7.27)%and(40.30±16.70)%,respectively.In the induced sputum of the EB group,the total number of cells was(5.46±3.07)×10^6 cells/g,the proportion of eosinophils accounted for(13.85±12.23)%,the proportion of neutrophils accounted for(46.16±16.89)%,the proportion of lymphocytes accounted for(4.83±2.98)%,and the monocyte-macrophages accounted for(35.91±16.35)%.The proportion of eosinophils was higher significantly in the EB group than the non-EB group(P<0.05).However,no significant difference was found in the sex,age or other cell components(P>0.05).After treatment in the EB group,the total number of cells was(4.70±3.89)×10^6 cells/g,and the proportion of eosinophils accounted for(2.52±3.80)%,neutrophils for(54.18±17.97)%,lymphocytes for(5.59±4.33)%,and monocyte-macrophages for(38.32±17.23)%in the induced sputum.The proportion of eosinophils after treatment was significantly reduced compared with that before treatment(P<0.05).Similarly,there was no significant difference in other cell changes(P>0.05).Conclusion Analyzing the induced sputum was an important method

关 键 词：诱导痰细胞分类 嗜酸细胞性支气管炎 诊断 治疗 

分 类 号：R563[医药卫生—呼吸系统]