哮喘患者白介素5和嗜酸粒细胞阳离子蛋白的改变

支气管哮喘的病理学特征之一是嗜酸粒细胞增多,由嗜酸粒细胞及其活性分泌产物嗜酸粒细胞阳离子蛋白(Ｅｏｓｉｎｏｐｈｉｌｃａｔｉｏｎｉｃｐｒｏｔｅｉｎ,ＥＣＰ)等引起的气道慢性炎症是支气管哮喘的主要发病机制之一[1]。本文检测嗜酸粒细胞数、ＩＬ5、ＥＣＰ以及ＩｇＥ和ＩＬ4含量,以探讨其在哮喘发病中的作用。1　对象和方法1.1　对象　轻、中度哮喘患者68例,其中男36例,女32例,年龄18～58(平均37)岁。诊断符合中华医学会呼吸病学会制订的支气管哮喘诊断标准[2]。检查均在发作期,无寄生虫病史。试验前1月内未用过皮质激素,1周内停服介质…     

检测哮喘患者诱导痰嗜酸粒细胞和嗜酸粒细胞阳离子蛋白及其意义

检测哮喘患者泼尼松治疗前后诱导痰嗜酸粒细胞 (EOS)和嗜酸粒细胞阳离子蛋白 (ECP)水平的变化 ,并和健康人群 ECP作比较 ,评价诱导痰液分析在哮喘气道炎症研究中的作用。1　资料与方法1.1　临床资料 :哮喘发作期患者 38例 ,男 2 0例 ,女 18例 ;年龄 13～ 6 5岁 ,平均41.0岁 ;其中轻度 12例 ,中、重度 2 6例。诊断符合文献〔1〕标准 ;6周内无用皮质激素史 ;无高血压、糖尿病、消化道溃疡、白内障及青光眼病史。患者均口服泼尼松 0 .5 mg· kg- 1· d- 1 ,疗程 6日。正常对照组为健康人 2 5例 ,男 13例 ,女12例 ;年龄 15～ 6 3岁 ,平均 39…     

血清嗜酸粒细胞阳离子蛋白、IgE 和外周血嗜酸粒细胞与儿童支气管哮喘关系的研究

目的：探讨儿童支气管哮喘严重程度与血清嗜酸粒细胞阳离子蛋白（eosinophil cationic protein,ECP）、总IgE（Total IgE,TIgE）、嗜酸粒细胞（eosinophils,EOS）水平的关系;了解儿童支气管哮喘常见过敏原,为儿童支气管哮喘的预防、病情判断及治疗提供依据。方法据儿童哮喘严重程度分级标准将95例哮喘患儿分为间歇发作组（n＝23）、轻度组（n＝29）、中度组（n＝23）、重度组（n＝20）四个组,选取20例健康体检儿作为对照组。采用ImmunoCAP100E体外过敏原检测系统定量测定血清ECP、TIgE、过敏原特异性IgE（Specific IgE,SIgE）的水平,Sysmex XT-2000i血球分析仪进行EOS计数。结果95例患儿吸入性过敏原SIgE阳性率为71.58%,以户尘螨、粉尘螨、屋尘为主,分别占69.47%、68.42%、32.63%;食入性过敏原SIgE阳性率为22.11%,以虾、螃蟹为主,分别占21.05%、18.95%。血清ECP在哮喘各组与对照组;轻、中、重三组间均有显著性差异,P均＜0.05,最高值出现在重度组。血清TIgE在轻度组、间歇发作组、对照组三组之间差异均无统计学意义,P均＞0.05。EOS在哮喘各组与对照组间均有显著性差异, P均＜0.05;在重度与中度,中度与轻度,轻度与间歇发作组间差异均无统计学意义,P均＞0.05。血清ECP水平与TIgE、EOS水平呈正相关（r＝0.615,P＜0.01;r＝0.533,P＜0.01）;TIgE水平与EOS水平呈正相关（r＝0.239,P＜0.05）。结论血清ECP水平更能准确地反映气道炎症的程度,较TIgE和EOS更为敏感,可作为临床检测气道炎症的客观指标。户尘螨、粉尘螨和屋尘是导致3岁以上儿童支气管哮喘病情发作的主要过敏原。     

支气管哮喘患儿血清中ECP和IL-5的测定及其临床意义

目的　探讨支气管哮喘患儿不同病期血清中嗜酸粒细胞阳离子蛋白 (ECP)和白细胞介素 5 (IL 5 )浓度变化及其临床意义。方法　用荧光酶联免疫法测定 40例哮喘发作组、2 5例缓解组和 15名正常对照组儿童血清ECP ,用酶联免疫吸附试验 (ELISA)测定IL 5水平。结果　哮喘发作组血清ECP浓度 [(10 .2 1± 1.9) μg/L]与正常对照组 [(1.94± 0 .5 ) μg/L]比较差异有显著性 (P <0 .0 1) ,而缓解组 [(2 .2 3± 0 .45 ) μg/L]与正常对照组比较差异无显著性 (P >0 .0 5 )。哮喘发作组、缓解组血清中IL 5水平分别 [(90 .0 2± 2 .4)ng/L、(2 5 .96± 1.7)ng/L]与正常对照组 [(9.94± 1.2 )ng/L]比较差异有显著性 (P <0 .0 1)。 结论　ECP和IL 5是参与哮喘发作过程的重要炎症介质 ,是判断哮喘变应性炎症的重要参考指标。     

支气管哮喘患儿血清中ECP和IL-5的测定及其临床意义

目的探讨支气管哮喘患儿不同病期血清中嗜酸粒细胞阳离子蛋白(ECP)和白细胞介素-5(IL-5)浓度变化及其临床意义.方法用荧光酶联免疫法测定40例哮喘发作组、25例缓解组和15名正常对照组儿童血清ECP,用酶联免疫吸附试验(ELISA)测定IL-5水平.结果哮喘发作组血清ECP浓度[(10.21±1.9)μg/L]与正常对照组[(1.94±0.5)μg/L]比较差异有显著性(P<0.01),而缓解组[(2.23±0.45)μg/L]与正常对照组比较差异无显著性(P>0.05).哮喘发作组、缓解组血清中IL-5水平分别[(90.02±2.4)ng/L、(25.96±1.7)ng/L]与正常对照组[(9.94±1.2)ng/L]比较差异有显著性(P<0.01).结论 ECP和IL-5是参与哮喘发作过程的重要炎症介质,是判断哮喘变应性炎症的重要参考指标.     

血清和诱导痰嗜酸粒细胞阳离子蛋白在检测哮喘气道炎症中的作用

传统观念认为哮喘是支气管平滑肌痉挛,气道狭窄所致,近年认识到哮喘的本质是一种慢性气道炎症,有多种炎症细胞、炎症介质和细胞因子参与其炎症过程.以往用于哮喘气道炎症研究的主要方法是进行支气管粘膜活检和支气管肺泡灌洗,但因其痛苦、安全性低,短期内难以重复等缺点而不能成为常规的检查手段.本研究应用双盲对照法检测一组哮喘患者强的松治疗前后血清和诱导痰嗜酸粒细胞阳离蛋白(ECP)水平的变化以及它们和健康人群血清、诱导痰ECP的比较,目的在于寻求检测哮喘气道炎症切实可行的方法. 1 对象和方法 1．1 研究对象：(1)观察组：哮喘患…     

哮喘病血清嗜酸性粒细胞阳离子蛋白测定及临床意义

目的探讨测定哮喘患者血清嗜酸性粒细胞阳离子蛋白( ECP)临床意义及理论根据.方法采用化学发光免疫测定 36例哮喘轻中度发作患者血清 ECP及肺功能最高峰值流速( PEF)和第 1秒用力呼气容量( FEVI),并予以吸入糖皮质激素(丙酸倍氯米松)治疗 3个月后以及停用丙酸倍氯米松 4周后各复查血清 ECP、肺功能.对照组 30例为非哮喘病人,仅测定血清 ECP.结果哮喘病人血清 ECP明显高于非哮喘者,有明显差异( P<0.01).停用吸入激素 4周后,哮喘患者血清 ECP复又升高,肺功能下降( P<0.01).结论血清 ECP是哮喘病一很好的疾病标记物,检测血清 ECP在哮喘病的诊断、疗效评价以及预后估计中有确切的临床意义.     

成人咳嗽变异型哮喘血清嗜酸粒细胞阳离子蛋白检测的临床意义

目的:探讨嗜酸粒细胞阳离子蛋白(ECP)在成人咳嗽变异型哮喘(CVA)中检测的意义。方法:通过对43例CVA患者“哮喘阶梯治疗方案”治疗前后进行第1秒用力肺活量(FEV1)和血清ECP浓度检测,同时取30例健康人作为对照组。结果:CVA组治疗前:FEV1及ECP与治疗后比较有显著性差异(P>0.01);CVA治疗前FEV1及ECP与对照组比较亦均有显著性差异(P<0.05)。结论:血清ECP水平与CVA病情变化一致。ECP浓度可反映CVA体内炎性细胞激活的程度,可作为气道炎症变化的指标,同时又可用于指导CVA的治疗。     

benralizumab在重症嗜酸粒细胞型哮喘治疗中的价值

支气管哮喘是一种常见的呼吸道慢性炎症性疾病,部分患者根据指南用药治疗后症状仍得不到控制,尤其在一些嗜酸粒细胞升高患者,吸入糖皮质激素及长效β2受体激动剂治疗后仍不能得到充分控制。benralizumab是一种人源化白细胞介素-5（IL-5）受体抗体,本文就benralizumab基本特性、临床应用现况、与其他IL-5抗体的比较以及应用前景等方面进行综述。     

哮喘患者血清ECP、IL-5、总IgE测定的临床意义

目的　进一步探讨支气管哮喘的发病机理。方法　分别采用免疫荧光法和固相酶联免疫吸附法 ,测定 32例支气管哮喘发作期 ,30例缓解期以及 30例正常对照组血清中ECP、IL 5、总IgE水平。结果　急性发作期支气管哮喘患者的ECP、IL 5、总IgE含量分别为 19.6 8± 7.4 3(μg/L)、89.2± 2 5 .9(ng/L)、5 2 4 .6± 138.7(KU/L) ;缓解期为 5 .76± 4 .2 5 (μg/L)、17.5± 7.3(ng/L)、2 91.3± 85 .4 (KU/L) ;正常对照组为 4 .86± 2 .4 8(μg/L) ,15 .1± 5 .6 (ng/L) ,10 3.2± 31.5 (KU/L)。哮喘急性发作期ECP、IL 5、总IgE分别比缓解期和正常对照组显著升高 (P <0 .0 0 1) ;ECP、IL 5二项缓解期与正常对照组无显著差异 (P >0 .0 5 ) ;总IgE缓解期比正常对照组显著升高 (P <0 .0 0 1)。结论　血液中ECP、IL 5、IgE一起参与了支气管哮喘的发病过程 ,测定三者的水平对判断支气管哮喘病情的进展有着十分重要的价值。     

孟鲁司特钠对儿童哮喘血和痰液嗜酸细胞阳离子蛋白及白细胞介素5的影响

目的　探讨孟鲁司特钠(顺尔宁)对儿童哮喘血和痰液嗜酸细胞阳离子蛋白(ECP)及白细胞介素5(IL- 5)的影响。方法　将60例6~14岁的中度哮喘儿童随机分为A组和B组,A组每日1次口服5 mg顺尔宁,B组吸入布地奈德(普米克都保)100μg,每日2次,两组均持续治疗12周;于治疗前和治疗后第12周临床评估和肺功能检查,同步血嗜酸性粒细胞(Eos)计数和检测血和痰液ECP和IL- 5 水平。结果　哮喘患儿治疗后临床症状和肺功能明显改善;治疗前哮喘患儿血ECP、IL 5水平和Eos计数均高于正常儿童对照组(P<0.01);血Eos计数与血ECP浓度存在显著正相关(P<0.01);血IL 5水平与ECP浓度呈显著正相关(P<0.01);治疗后血ECP、IL -5 水平和Eos计数较治疗前降低,差异有统计学意义(P<0.01);痰液ECP和IL- 5含量低于治疗前,差异有统计学意义(P<0.01)。结论　顺尔宁降低血和痰液的ECP和IL- 5水平,在哮喘的抗炎机制中起重要用。     

Serum eosinophil cationic protein in asthma of farmers

Objective: There is need for relevant markers of bronchial inflammation in epidemiologic studies of asthma. Serum eosinophil cationic protein (ECP) is a marker of eosinophil inflammation and asthma activity. We have studied serum ECP in atopic farmers with current asthma, in non-atopic asthmatics and in non-asthmatic, non-atopic controls. Methods and results: In a cross-sectional study of a representative sample of 8482 farmers in Norway, asthma was recorded using a self-administered questionnaire; spirometry and serum sampling were performed on all of them. Atopy was screened with Phadiatop and RAST analyses to the mites Lepidoglyphus destructor and Tyrophagus putrescentiae in all asthma cases and controls. All the identified atopics had additional RAST analyses on a set of allergens. Serum ECP was tested in 60 persons with current asthma and atopy (mean 16.2, 95% CI 13.2-19.3), 127 non-atopic asthmatics (mean 9.1, 95% CI 8.0-10.2) and 39 non-atopic controls (mean 5.5, 95% CI 4.0-7.0). ECP levels in atopic asthmatics were associated with number of positive allergens and reduction of FEV1 values. Moreover, the ECP levels were elevated with allergy to swine, cow, D. pteronyssinus, L. destructor, A. siro, T. putrescentiae, timothy grass and the cereal grains: wheat, oat, barley and rye. Conclusion: Serum ECP seems feasible as an indicator of inflammatory activity in epidemiological studies of current allergic asthma, and may help to indicate the importance of specific allergens. Although the ECP values were significantly more elevated in atopic than in non-atopic asthma, elevated serum ECP was not specific for atopic asthma.     

Serum eosinophil cationic protein in asthma of farmers

OBJECTIVE: There is need for relevant markers of bronchial inflammation in epidemiologic studies of asthma. Serum eosinophil cationic protein (ECP) is a marker of eosinophil inflammation and asthma activity. We have studied serum ECP in atopic farmers with current asthma, in non-atopic asthmatics and in non-asthmatic, non-atopic controls. METHODS AND RESULTS: In a cross-sectional study of a representative sample of 8,482 farmers in Norway, asthma was recorded using a self-administered questionnaire; spirometry and serum sampling were performed on all of them. Atopy was screened with Phadiatop and RAST analyses to the mites Lepidoglyphus destructor and Tyrophagus putrescentiae in all asthma cases and controls. All the identified atopics had additional RAST analyses on a set of allergens. Serum ECP was tested in 60 persons with current asthma and atopy (mean 16.2, 95% CI 13.2-19.3), 127 non-atopic asthmatics (mean 9.1, 95% CI 8.0-10.2) and 39 non-atopic controls (mean 5.5, 95% CI 4.0 7.0). ECP levels in atopic asthmatics were associated with number of positive allergens and reduction of FEVI values. Moreover, the ECP levels were elevated with allergy to swine, cow, D. pteronyssinus, L. destructor, A. siro, T. putrescentiae, timothy grass and the cereal grains: wheat, oat, barley and rye. CONCLUSION: Serum ECP seems feasible as an indicator of inflammatory activity in epidemiological studies of current allergic asthma, and may help to indicate the importance of specific allergens. Although the ECP values were significantly more elevated in atopic than in non-atopic asthma, elevated serum ECP was not specific for atopic asthma.     

Predictive capabilities of serum eosinophil cationic protein, percentage of eosinophils and total immunoglobulin E in allergic rhinitis without bronchial asthma

This study identified cut-off values for allergy markers for use in the diagnosis of allergic rhinitis in the absence of other allergic diseases. Total immunoglobulin E (IgE), eosinophil cationic protein (ECP) and the numbers of eosinophils were measured in serum samples from 442 patients with typical symptoms of allergic rhinitis. A definite diagnosis was made on the basis of the presence of specific IgE levels. Cut-off values with a maximal discrimination to diagnose allergic rhinitis were found to be 98.7 IU/ml, 24.7 μg/ml and 4.0% for total IgE, ECP and eosinophils, respectively. Sensitivity, specificity and odds ratio for these values were 75.2%, 69.7% and 6.93, respectively, for total IgE, 55.7%, 74.4% and 3.70 for ECP, and 57.5%, 72.0% and 3.47 for eosinophils. A composite score representing positive results for all three markers had a positive predictive value of 85.3%, with an odds ratio of 8.55. It was concluded that total serum IgE, ECP and eosinophil percentage are strong predictors of allergic rhinitis and the determination of cut-off values for these markers can aid in the diagnosis of allergic rhinitis in the clinical setting.     

冠心病患者血清嗜酸细胞阳离子蛋白变化临床意义

目的:探讨冠心病患者血清嗜酸细胞阳离子蛋白(eosinophil cationic protein,ECP)与超敏C反应蛋白(high sensitivity C-reactive protein,hs-CRP)的关系及变化的临床意义.方法:63例冠心病患者分为稳定性心绞痛(stable angina,SAP)组27例和急性冠状动脉综合征(acute coronary syndrome,ACS)组36例;冠状动脉造影正常者26例为对照组.于冠状动脉造影前采集静脉血,应用酶联免疫法检测血清ECP水平,用胶乳增强免疫比浊法检测hs-CRP水平.结果:SAP组和ACS组血清ECP高于对照组(均P<0.05),ACS组hs-CRP水平高于对照组和SAP组(均P<0.05);与对照组比较,SAP组冠状动脉狭窄程度积分、病变范围积分明显增高(均P<0.05),与对照组和SAP组比较,ACS组冠状动脉狭窄程度积分、病变范围积分明显增高(均P<0.05).ECP是冠状动脉狭窄程度积分的独立预测因子(β=0.45,SE=0.02,P<0.01).结论:血清ECP水平对评价ACS患者冠状动脉病变严重程度有一定临床意义,可作为冠心病的临床标志物.     

白细胞介素-4、白细胞介素-8、白细胞介素-9在支气管哮喘患儿血清中的表达及临床意义

目的 观察白细胞介素(IL)-4、IL-8、IL-9在支气管哮喘患儿血清中的表达,并探讨其临床意义.方法 选取支气管哮喘急性发作期、临床缓解期患儿各43例,分别设为发作组和缓解组,另选取同期体检健康儿童37例作为对照组,检测所有儿童的血清IL-4、IL-8、IL-9水平.结果 IL-4、IL-8、IL-9在对照组、缓解组、发作组儿童血清中的表达水平均呈递增趋势,组间比较均有显著差异(P＜0.01).结论 血清IL-4、IL-8、IL-9水平与支气管哮喘的发生、发展过程密切相关,临床可作为支气管哮喘病情进展的参考指标.     

超短波和胸壁振动辅助治疗对轻、中度儿童哮喘诱导痰EOS及血清ECP的影响

目的探讨超短波和胸壁振动辅助治疗儿童哮喘对诱导痰嗜酸粒细胞百分数（EOS%）、血清嗜酸粒细胞阳离子蛋白（ECP）及肺通气功能的影响。 方法68例哮喘儿童随机分为对照组和治疗组，对照组采用常规治疗，治疗组除常规治疗外，先后行超短波和胸壁振动辅助治疗，并分别于治疗前、后采血测ECP，行肺通气功能检查及诱导痰EOS%分类。 结果哮喘儿童诱导痰EOS%、血清ECP与肺通气功能指标第1秒最大呼气量占预计值的百分数（FEV1.0%）及呼气峰流速占预计值的百分数（PEF%）均呈显著负相关（P<0.01）；与对照组比较，治疗后治疗组血清ECP、诱导痰EOS%均显著降低，FEV1.0%、PEF%显著升高（P<0.05或0.01）。 结论超短波和胸壁振动辅助治疗儿童哮喘具有减轻气道炎症和气道受阻、提高肺通气功能的作用。     

血白细胞介素-5及嗜酸细胞阳离子蛋白检测在呼吸道合胞病毒感染毛细支气管炎中的意义

目的 探讨呼吸道合胞病毒(RSV)感染毛细支气管炎患儿血中白细胞介素-5(IL-5)及嗜酸细胞阳离子蛋白(ECP)含量变化的意义.方法 将63例住院的毛细支气管炎患儿按病情分成轻度组(19例),中度组(25例),重度组(19例),年龄(8.7±0.1)岁.采用酶联免疫吸附试验(ELISA)测定各组患儿血IL-5及ECP含量.结果 中度组及重度组血IL-5 (ng/L)含量均明显高于轻度组(13.03±3.54,16.39±3.40比10.05±2.72,均P＜0.01),而血ECP含量(μg/L)在轻、中、重度组间差异无统计学意义(2.46±0.44、2.47±0.46、2.68±0.53,均P＞0.05).结论 在RSV感染的毛细支气管炎患儿中,检测血IL-5的含量变化能及时反映呼吸道炎症活动情况及疾病的严重程度,而检测血ECP的含量变化不具备提示炎症或疾病严重程度的作用.     

Circulating histamine and eosinophil cationic protein levels in nocturnal asthma.

1. To investigate the role of mast cells and eosinophils in the pathogenesis of nocturnal asthma, the plasma methylhistamine concentration, serum eosinophil cationic protein level and peak expiratory flow rate were measured 2-hourly for 24 h in 10 patients with nocturnal asthma and in 10 healthy control subjects. Nocturnal asthma was defined as at least one nocturnal awakening per week due to cough, wheeze or breathlessness with an average overnight fall in peak expiratory flow rate of at least 15% during a 2-week run-in period. 2. The lowest peak expiratory flow rate occurred at 02.00-04.00 hours in the group with nocturnal asthma, whose overnight fall in peak expiratory flow rate was 29 +/- 5% in comparison with 5 +/- 1% (means +/- SEM) in the normal subjects. 3. Plasma methylhistamine levels at night (0.200-04.00 hours) were lower than during the day (10.00-20.00 hours) in both asthmatic patients and normal subjects (asthmatic patients: day, median 0.22 ng/ml, 95% confidence intervals 0.18-0.34 ng/ml; night, 0.17 ng/ml, 0.13-0.24 ng/ml; P < 0.01; normal subjects: day, 0.31 ng/ml, 0.24-0.41 ng/ml; night, 0.24 ng/ml, 0.21-0.33 ng/ml; P < 0.01). 4. The serum eosinophil cationic protein level was higher by day (30 ng/ml, 8-47 ng/ml) than by night (21 ng/ml, 5-34 ng/ml; P < 0.04) in the group with nocturnal asthma, but did not change significantly with the time of day in the normal subjects (day: 8 ng/ml, 4-14 ng/ml; night: 8 ng/ml, 5-21 ng/ml).(ABSTRACT TRUNCATED AT 250 WORDS)