Lung reflexes and receptor activity in a rabbit model of pulmonary fibrosis

Our objective was to see if activity of individual slowly and rapidly adapting pulmonary receptors was changed by pulmonary fibrosis. Diffuse interstitial lung fibrosis of several weeks’ standing was induced in 8 rabbits. They displayed changes in lung mechanics and patterns of breathing, when compared to control rabbits, similar to those seen in patients who develop pulmonary fibrosis. Lung reflexes in the fibrotic rabbits were more profoundly changed than eupneic breathing in a way that could be interpreted as slowly adapting receptor activity, which was increased, being overpowered by a prepotent input from pulmonary rapidly adapting receptors. An increase in number of active rapidly adapting receptors was found in the fibrotic rabbits during direct vagal recording. We have demonstrated that pulmonary receptor activity is changed by lung fibrosis. It may be that these changes in receptor activity produce conflicting respiratory drives that could result in the sensation of dyspnea.     

Capsaicin exposure elicits complex airway defensive motor patterns in normal humans in a concentration-dependent manner

The airway defensive response to tussive agents, such as capsaicin, is frequently assessed by counting the number of cough sounds, or expulsive events. This method does not identify or differentiate important respiratory events that occur in the respiratory muscles and lungs, which are critical in assessing airway defensive responses. The purpose of this study was to characterize the airway defensive behaviours (cough and expiration reflex) to capsaicin exposure in humans. We observed complex motor behaviours in response to capsaicin exposure. These behaviours were defined as cough reacceleration (CRn) and expiration reflex (ERn), where n is the number of expulsive events with and without a preceding inspiratory phase, respectively. Airway defensive responses were defined in terms of frequency (number of expulsive events), strength (activation of abdominal muscles) and behaviour type (CRn vs. ERn). Thirty-six subjects (15 females, 24+/-4 yr) were instrumented with EMG electrodes placed over the rectus abdominis (RA), external abdominal oblique (EO) and the 8th intercostal space (IC8). A custom-designed mouth pneumotachograph was used to assess the airflow acceleration, plateau velocity and phase duration of the expulsive phase. Subjects inhaled seven concentrations of capsaicin (5-200 microM) in a randomized block order. The total number of expulsive events (frequency) and the sum of integrated EMG for the IC8, RA and EO (strength) increased in a curvilinear fashion. Differentiating the airway defense responses into type demonstrated predominately CR1 and CR2 (i.e. inspiration followed by one and two expulsive events, respectively) with very few ER's at <50 microM capsaicin. At higher concentrations (>50 microM) ER's with one or more expulsive events (ER1) appeared, and the number of CR's with three or more expulsive events (CR3) increased. The decrease in EMG activation and airflow measurements with each successive expulsive event suggests a decline in power and shear force as the number of expulsive events increased. Therefore, the airway defensive response to capsaicin is a complex motor pattern that functions to coordinate ER's and CR's with differing numbers of expulsive events possibly to prevent aspirations and keep air moving to promote clearance.     

尿道括约肌肌电图对多系统萎缩的诊断价值

  目的 探讨尿道括约肌肌电图检查对多系统萎缩(MSA)的诊断价值。方法 对15例MSA患者进行尿道括约肌肌电图检查,同时选取17例非MSA患者作为对照组进行相应的检查。比较两组患者尿道括约肌肌电图中轻收缩时平均运动单位时限、平均波幅、多相波百分比、卫星电位出现率,以及大力收缩时的变化。对两组资料各参数进行统计分析。结果 MSA组13例(86.7%)尿道括约肌肌电图明显异常,与对照组相比,运动单位电位时限［（12.79±3.18）ms比（9.49±1.51）ms］,轻收缩波幅［（828.53±459.89)μV比(378.76±152.26）μV］,多相波［（11.47±21.55)%比(8.23±10.74）%］,大力收缩波幅［（2.19±1.24)mV比(0.75±0.42）mV］差异均有统计学意义（P值均<0.05）。结论 尿道括约肌肌电图检查对MSA的诊断有一定的价值,在怀疑MSA时该项检查可作为常规的电生理检查方法,并能起到肛门括约肌肌电图的补充和替代作用。     

Laryngeal involvement in rheumatoid arthritis

Rheumatoid arthritis (RA) is a chronic inflammatory disease affecting the synovial membrane, which causes joint damage and bone destruction. Extra-articular manifestations are numerous, involving multiple organ systems. Rheumatoid nodules are common extra-articular findings occurring in 20% RA patients. They develop most commonly in pressure areas (elbows and finger joints) and may occasionally affect internal organs including pleura, lungs, meninges, larynx, and others. Furthermore, RA affects the ear, nose, and throat, causing various otorhinolaryngological symptoms. In this report we describe two patients with RA and laryngeal involvement, mostly rheumatoid nodule formation, with a review of the literature.     

感冒后咳嗽敏感性及气道神经源性炎症改变

目的观察感冒后咳嗽患者(cough post infectious,CPI)的咳嗽敏感性以及气道分泌物神经肽变化,探讨其可能的发病机制。方法以2005年1~6月于广州呼吸疾病研究所慢性咳嗽专科门诊诊断10例CPI患者(CPI组)及10名正常志愿者(正常对照组)为研究对象,通过辣椒素咳嗽激发试验测定气道咳嗽敏感性;观察诱导痰细胞总数以及细胞分类比例;测定痰上清液P物质(SP)、神经肽A(NKA)、神经肽B(NKB)及降钙素基因相关肽(CGRP);检测诱导痰细胞SP、NKA及SP受体(NK-1)的表达,并进行分析比较。结果CPI组咳嗽阈值lgC5为1.16±0.61,明显低于正常对照组(2.64±0.28)(P<0.001)。CPI组诱导痰细胞总数(WBC)及细胞分类比例与正常对照组差异均无显著性意义。CPI组诱导痰上清液SP质量浓度为(516.3±494.2)ng/L,显著高于正常对照组[(141.7±34.5)ng/L,P<0.05];CGRP质量浓度为(141.2±80.8)ng/L,显著高于正常对照组[(74.3±38.2)ng/L,P<0.05];而2组间NKA、NKB的质量浓度差异均无显著性意义。CPI组痰细胞SP、NK-1蛋白的表达分别为1.86±0.81和1.20±0.75,显著高于正常对照组的(0.65±0.44和0.27±0.24)(P<0.01);而2组间NKA蛋白表达差异无显著性意义。结论CPI患者的咳嗽敏感性增高,并伴随气道神经源性炎症,提示其与CPI发病相关。     

Short-term postural reflexes in diabetic patients with autonomic dysfunction

Aims/hypothesis Assessment of autonomic dysfunction provides prognostic data in diabetic patients. Clinical tests are limited to heart rate variability and blood pressure measurements. We investigated whether a detailed analysis of postural reflexes of patients during short-term head-up tilting and standing erect (both for 3 min) would provide useful clinical data.Methods We studied 14 control subjects and 56 patients with Type 2 diabetes, stratified into four matched groups: uncomplicated, micro-albuminuria, marco-albuminuria and autonomic neuropathy, who were tilted 55° three times and were standing erect. Non-invasive finger plethysmography blood pressure measurements, using the Portapres, and impedance cardiac output measurements, using the RheoCardioMonitor, were continuously recorded throughout the study. Wavelets of the response to tilting and standing were drawn. The wavelets for the three tilts were combined to improve definition. The degree of autonomic dysfunction was quantified by calculating the baroreflex sensitivity index from the heart-rate and blood-pressure variability data.Results Baroreflex sensitivity data confirmed that autonomic dysfunction increased as diabetic complications worsened (p<0.001). Both standing and tilting resulted in an initial decrease in blood pressure followed by recovery, an increase in heart rate which was more pronounced with standing and a decrease in stroke volume. Characteristic and incremental changes in these responses were noted as the complications of diabetes worsened (p<0.001). These were a greater decrease in blood pressure with loss of the recovery phase, a reduced heart-rate response and paradoxically an increase in stroke volume.Conclusion/interpretation Non-invasive blood-pressure and stroke-volume measurements recorded during short-term tilting and standing promises to be useful in assessing diabetic autonomic dysfunction.Abbreviations UAER urinary albumin excretion rate - HR heart rate - SAP systolic arterial blood pressure - MAP mean arterial blood pressure - SV stroke volume - CO cardiac output - TPR total peripheral resistance - D diabetic patients without complications - DI diabetic patients with micro-albuminuria - DA diabetic patients with macro-albuminuria - AN diabetic patients with autonomic neuropathy     

多系统萎缩与帕金森病患者肺及呼吸肌功能检测意义

目的 评估多系统萎缩(MSA)和帕金森病(PD)患者的呼吸功能.方法 对临床诊断的16例MSA、20例PD患者及17例年龄、性别匹配的正常对照者行肺及呼吸肌功能测定.结果 MSA组较PD组肺一氧化碳弥散量(DLCO)占预测值百分比降低[(62.86±15.66)％比(76.67±18.98)％,P＜0.05].两组最大吸气压(MIP)占预测值百分比[MSA组(39.08±22.99)％、PD组(39.83±24.83)％比对照组(57.44±19.90)％,P＜0.05]、最大呼气压(MEP)占预测值百分比均较对照组均降低[MSA组(49.59±22.97)％、PD组(49.26±22.86)％比对照组(77.10±21.46)％,P＜0.001].结论 临床相对常见神经系统变性病MSA和PD均存在呼吸功能受累,以呼吸力学功能障碍为著;MSA患者可能还存在肺换气功能障碍.应重视神经变性病患者呼吸功能.     

Prolonged QTc interval and its relationship to autonomic cardiovascular reflexes in patients with cirrhosis

BACKGROUND/AIMS: We have previously shown that an abnormality in cardiac autonomic reflexes (AN) is an independent predictor of mortality in patients with chronic liver disease. Aim of this study was to determine whether there was an association between prolonged QTc interval and cardiac AN. METHODS: Cardiac AN and QTc interval were determined in 130 patients (Child A 42, B 53, C 35) with alcoholic and non-alcoholic liver disease. RESULTS: Prolonged QTc (>440ms) was seen in 58 (Child A 30%, B 46%, C 60%, P=0.04) patients. Autonomic tests were normal in 21%, borderline abnormal in 36% and definitely abnormal in 43%. QTc correlated with albumin (P<0.001), prothrombin time (P=0.003) and Child-Pugh score (P<0.001), but not with Valsalva ratio, heart rate variation with 6 breath/min breathing, tilt table or isometric exercise. By logistic regression analysis, QTc correlated only with Child-Pugh score (P<0.001). Mean QTc of 34 who died during the follow up was higher than survivors. Cox regression analysis showed that only Child-Pugh score and AN were independent predictors of mortality. CONCLUSIONS: Prolonged QTc seen in liver disease is independent of their cardiac autonomic function, but is related to the severity of the liver disease.     

多系统萎缩和帕金森病患者的磁共振影像学分析

目的 探讨多系统萎缩(multiple system atrophy,MSA)和帕金森病(Parkinson disease,PD)的磁共振成像(MRI)影像学特点,为早期诊断和鉴别诊断提供依据.方法 回顾性分析经临床确诊的24例MSA、30例PD和30例健康人的MRI资料,观察指标包括:(1)T2WI信号改变:十字征(即脑桥基底部十字样高信号)、裂隙征(即壳核外侧缘裂隙样高信号);(2)脑室、脑池扩大:四脑室、桥池、延池;(3)脑实质萎缩:延髓、脑桥、小脑中脚、壳核萎缩.并测量中脑面积、脑桥面积和小脑中脚宽度.结果 MSA患者中均出现至少1项MRI异常指标,并表现一定的分型差异.敏感性较高的指标是:小脑中脚萎缩(79.2%)、脑桥萎缩(79.2%)和十字征(75.0%);特异性和阳性预测值高的指标是:十字征(均为100%)、裂隙征(均为100%)、小脑中脚萎缩(93.3%和90.1%)、脑桥萎缩(96.7%和95.0%).MSA组脑桥面积、中脑面积及小脑中脚宽度分别为(288.7±75.4)mm2、(127.8±25.8)mm2及(10.7±2.8)mm,与PD组[分别为(477.5±54.3)mm2、(145.9±21.6)mm2及(16.2±1.3)mm]、对照组[分别为(454.5±36.8)mm2、(146.4±17.4)mm2及(16.7±1.2)mm]比较,差异有统计学意义(P＜0.05).结论 MRI有助于MSA的诊断及其与PD的鉴别诊断,对MSA的分型具有一定的价值.

Abstract：

Objective To explore the MRI features of patients with multiple system atrophy (MSA) and Parkinson's disease (PD) for providing early evidence in differential diagnosis. Methods The MRI features of 24 patients with MSA, 30 patients with PD and 30 healthy people as controls were retrospectively analyzed. Abnormal intensity in MRI included the hot-cross bun sign and the slitlike changes. The atrophies of brain included cerebellar, middle cerebellar peduncles, medulla oblongata and pon. Cerebral ventricle dilatation included fourth ventricle and cisterna pontis. The midbrain area, pons area and middle cerebellar peduncles width were measured. Results All patients with MSA had at least one of the features observed on MR images, and there were some differences in the subtypes of MSA. The high sensitive features were the atrophies of middle cerebellar peduncles (79.2%), the atrophies of pons (79.2%) and the hot-cross bun sign (75.0%). The parameters with high specificity and high positive predictive value were hot-cross bun sign (both 100%), the slit-like sign (both 100%), the atrophies of middle cerebellar peduncles (93.3% and 90.1%), and the atrophies of pons (96.7% and 95.0%). MSA group had the statistically significantly decreased values of pons area, midbrain area and middle cerebellar peduncles width [(288. 7±75. 4) mm2, (127.8±25.8) mm2 and (10. 7±2.8) mm, respectively], as compared with PD group [(477. 5 ± 54. 3) mm2, (145.9±21.6) mm2 and (16.2±1.3) mm, respectively] and healthy group [(454. 5±36. 8) mm2 , (146.4±17.4) mm2 and (16.7±1.2) mm, respectively] (all P ＜0. 05). Conclusions The routine MRI is helpful in differential diagnosis between MSA and PD and has some values in diagnosing the subtypes of MSA.     

不同病因儿童慢性咳嗽气道高反应的特征

目的 研究不同病因儿童慢性咳嗽的气道高反应性(AHR)特征.方法 纳入2012年4月至2013年12月于苏州大学附属儿童医院呼吸科就诊并明确为单病因的慢性咳嗽患儿,采用支气管激发试验测得FEV1下降20％时组织胺累计剂量(PD20),依据PD20将AHR严重程度分为重度、中度、轻度、极轻度4级,同时测定诱导痰嗜酸粒细胞(EOS)计数和呼出气一氧化氮(FeNO)浓度,按儿童慢性咳嗽指南推荐方案进行治疗,4周后随访,复查上述指标.结果 共纳入患儿66例,其中咳嗽变异性哮喘(CVA)17例,上气道咳嗽综合征(UACS) 37例,感染后咳嗽(PIC) 12例.CVA、UACS及PIC组AHR阳性初诊例数分别为17、13和9例,4周复诊时分别为17、5和2例.AHR严重程度分级,初诊时CVA、UACS和PIC组中～重度分别为5、0和0例,轻度～极轻度分别为12、13和9例,阴性分别为0、24和3例;4周后复诊CVA、UACS和PIC组中～重度度分别为1、0和0例,轻度～极轻度分别为16、5和2例,阴性分别为0、32和10例.CVA组PD20值为(0.47±0.28) mg,低于UACS组和PIC组[分别为(1.80±0.64)和(1.20±0.80) mg],差异均有统计学意义(均P＜0.01).CVA组的诱导痰EOS比例均＞3％,UACS和PIC组均＜3％.FeNO与痰EOS比例呈正相关(r=0.687,P=0.000).结论 不同病因儿童慢性咳嗽气道高反应的严重程度和持续时间不同,气道激发试验结合诱导痰对慢性咳嗽病因诊断有重要价值.     

多系统萎缩老年患者早期临床特点分析

目的 探讨多系统萎缩(MSA)的早期的临床表现及发病特点,为早期诊断提供依据.方法 回顾性分析我院102例诊断“很可能”的MSA老年患者首发症状、临床特点及辅助检查等,结合文献进行复习. 结果 102例诊断为“很可能”的MSA老年患者,其中诊断为MSA-P亚型57例(55.9％),MSA-C亚型45例(44.1％).首发症状以自主神经功能障碍27例,在MSA-P亚型与MSA-C亚型中分别为15例(26.3％)和12例(26.6％),主要表现为排尿、排便障碍14例,直立性低血压11例,性功能障碍8例.首发症状以帕金森样症状49例,主要表现为步态异常24例,静止性震颤3例,肌强直16例,动作迟缓15例.首发症状以小脑症状33例,主要表现为步态、肢体共济失调27例,构音障碍6例,眼球震颤2例.首发锥体束征2例.早期发生误诊36例(35.3％). 结论 MSA早期表现多样,容易被误诊.注意临床表现和辅助检查,提高临床早期诊断的准确性.     

Impaired exocrine pancreatic function in diabetics with diarrhea and peripheral neuropathy

Exocrine pancreatic insufficiency has been observed in some diabetics with peripheral neuropathy and diarrhea. Several mechanisms may be responsible for this insufficiency: (1) pancreatic atrophy, (2) disruption of the cholinergic enteropancreatic reflexes, or (3) elevated serum levels of peptides such as glucagon and pancreatic polypeptide which are known to inhibit pancreatic exocrine secretion. To clarify the mechanism(s) involved in this exocrine pancreatic impairment, we studied 10 diabetics with diarrhea and peripheral neuropathy. Their results were compared to those of eight normal volunteers. Each subject underwent a standardized pancreatic function study which assessed nonstimulated secretion, the response to intrajejunal infusion of a mixture of amino acids, and the output following intravenous administration of secretin and cholecystokinin (CCK). In separate studies, the effect of a background infusion of bethanechol and secretin on the pancreatic response to CCK was assessed in six patients and six normal controls. Compared to normals, all diabetics exhibited a significant reduction in both enzyme and bicarbonate secretion to all stimuli. This reduction was not corrected by administering bethanechol. Plasma glucagon and pancreatic polypeptide levels in diabetics were not significantly higher than those in controls. We conclude that diabetics with diarrhea and peripheral neuropathy exhibit impairment of their exocrine pancreatic secretion and possible mechanisms for this are discussed.Dr. Staples was a USC Medical Student during this protocol.     

Selective Loss of Expression of Glutamate GluR2/R3 Receptor Subunits in Cerebellar Tissue from a Patient with Olivopontocerebellar Atrophy

Expression of the mRNAs encoding the astrocytic (EAAT1, EAAT2) and neuronal (EAAT3, EAAT4) excitatory amino acid transporters and the AMPA-type glutamate receptor subunits GluR2 and GluR3 was investigated in postmortem cerebellar extracts from a patient with olivopontocerebellar atrophy (OPCA) and in material from three age-matched controls. Decreased expression in the steady state level of EAAT4 mRNA in the OPCA sample was correlated with the selective loss of Purkinje cells. Neuropathological evaluation revealed reactive gliosis and concomitantly increased expression of the mRNA encoding astrocytic glial fibrillary acidic protein (GFAP). Expression of the mRNAs encoding the AMPA receptor subunits GluR2 and GluR3 subunits was found to be decreased in OPCA suggesting that excitotoxic mechanism could play a role in the pathogenesis of the selective neuronal cell death in this disorder.     

SLIPA喉罩和食管引流型喉罩在老年人腹腔镜胆囊切除手术中的应用

目的 比较(SLIPA)喉罩和食管引流型喉罩(PLMA)用于老年腹腔镜胆囊切除手术患者气道管理的效果. 方法 拟择期行腹腔镜手术患者120例,年龄60～75岁,美国麻醉医师协会(ASA)分级Ⅰ或Ⅱ级,随机分为3组,每组40例:气管插管组,SLIPA组和PLMA组.麻醉诱导后置入气管导管或喉罩,行间歇正压通气.记录麻醉诱导前(T0)、管(罩)置入成功即刻(T1)、气腹后10min(Ta)、拔除时(T3)、拔除后10 min(T4)平均动脉压及心率.记录管(罩)置入情况、置入时间、测定气道密封压.记录拔除管(罩)时呛咳、返流、误吸及喉痉挛的发生情况;管(罩)拔除后粘血及胃胀气的发生情况;术后2d内咽痛的置入发生情况. 结果 气管插管组、SLIPA组、PLMA组1次置入成功率分别为92.5％、92.5％、95.0％(x2=0.268,P＞0.05),2次置入成功率均为100.0％.气管插管组在麻醉诱导后和SLIPA组、PLMA组比较,患者的血流动力学变化有明显差异(t=4.076,P＜0.05).SLAPA组喉罩置入时间较气管插管组和PLMA组短,喉罩置入容易(t=43.561,P＜0.05).PLMA组喉罩气道密封压较SLIPA组高,但差异无统计学意义(￡=0.363,P＞0.05).3组患者反流、误吸、喉痉挛和胃胀气的发生率差异无统计学意义(t=0.321,P＞0.05);SLIPA组和PLMA组呛咳和咽痛的发生率低于气管插管组(分别为x2=26.674,10.568,均P＜0.05). 结论 SLIPA和PLMA喉罩均可保证有效通气,不良反应少.SLAPA喉罩置入更简单,而PLMA喉罩气道密封效果较好,更适用于老年腹腔镜胆囊切除手术患者.     

Structural differentiation of skeletal muscle fibers in the absence of innervation in humans

The relative importance of muscle activity versus neurotrophic factors in the maintenance of muscle differentiation has been greatly debated. Muscle biopsies from spinal cord injury patients, who were trained with an innovative protocol of functional electrical stimulation (FES) for prolonged periods (2.4-9.3 years), offered the unique opportunity of studying the structural recovery of denervated fibers from severe atrophy under the sole influence of muscle activity. FES stimulation induced surprising recovery of muscle structure, mass, and force even in patients whose muscles had been denervated for prolonged periods before the beginning of FES training (up to 2 years) and had almost completely lost muscle-specific internal organization. Ninety percent (or more) of the fibers analyzed by electron microscopy showed a striking recovery of the ultrastructural organization of myofibrils and Ca(2+)-handling membrane systems. This functional/structural restoration follows a pattern that mimics some aspects of normal muscle differentiation. Most importantly, the recovery occurs in the complete absence of motor and sensory innervation and of nerve-derived trophic factors, that is, solely under the influence of muscle activity induced by electrical stimulation.     

支气管哮喘、咳嗽变异性哮喘及急性支气管炎气道反应性特点及意义

目的探讨支气管哮喘、咳嗽变异性哮喘及急性支气管炎气道反应性特点,以便为临床诊断提供依据。方法采用日本产ＡＳＴＯＧＡＰＨＴＣＫ６０００ＣＶ气道反应测定仪,以乙酰甲胆碱为气道激发剂,观察６０例支气管哮喘、５８例咳嗽变异性哮喘及３７例急性支气管炎患者气道反应性变化。结果支气管哮喘和咳嗽变异性哮喘病人气道激发试验均为阳性,哮喘病人的气道反应阈值（Ｄｍｉｎ）低于咳嗽变异性哮喘病人（Ｐ＜００５）。急性支气管炎病人中,气道激发试验３３例阴性,占８９％,４例阳性,占１１％。４例阳性急性支气管炎患者的气道反应性曲线与哮喘组及咳嗽变异性哮喘组明显不同,其Ｄｍｉｎ也显著高于哮喘组（Ｐ＜００１）及咳嗽变异性哮喘组（Ｐ＜００５）。结论气道反应性测定对于不同类型哮喘及急性支气管炎的鉴别和指导治疗具有很好的临床应用价值。     

呼吸道感染后咳嗽与咳嗽变异性哮喘痰炎症细胞和气道反应性特点及其意义

目的探讨呼吸道感染后咳嗽与咳嗽变异性哮喘患者痰炎症细胞的特点及其临床意义。方法收集呼吸道感染后咳嗽（Ⅰ组,22例）和咳嗽变异性哮喘（Ⅱ组,24例）患者痰或高渗盐水诱导痰,作瑞氏染色后细胞涂片,并在显微镜下细胞分类计数,测定其通气功能和乙酰甲胆硷吸入测定气道反应性。结果Ⅰ组和Ⅱ组痰液炎症细胞总数分别为8．22×10^9／L和8．94×10^9／L,两组比较无统计学意义（P〉0．05）;而Ⅰ组嗜酸细胞和中性粒细胞的中位数分别为0．20％、5．88％,与Ⅱ组比较,两种细胞（分别为9．62％、2．48％）的组间比较差异均有显著性（P〈0．01）。Ⅱ组的气道反应性（支气管激发试验阳性100％,其PC20为1．24g／L）明显高于Ⅰ组（支气管激发试验阳性16．7％,且其PC10较高,为4．85g／L,P〈0．01）。咳嗽变异性哮喘组痰液嗜酸细胞与气道反应性指标PC10成呈显著负相关（r=-0．56,P〈0．01）。结论呼吸道感染后咳嗽与咳嗽变异性哮喘痰炎症细胞特点不同,痰中炎症细胞检查和气道反应性测定,可作为鉴别呼吸道感染后咳嗽与咳嗽变异性哮喘的一项参考指标。