痰液细胞在哮喘患儿病程中的动态变化及意义

目的　观察哮喘患儿痰液细胞在病程不同时相的动态变化 ,探讨其在哮喘发病中的作用。方法　收集 2 5例哮喘患儿发作之初、病情好转以及病情缓解时期的痰液 ,比较哮喘病程不同时相之间以及不同时相与 10例正常儿童之间痰液细胞成分的差异。结果　哮喘急性发作初期痰液脱落上皮细胞明显增多 ,嗜酸性粒细胞、中性粒细胞和淋巴细胞与正常对照无明显差别 ;随着病情好转 ,脱落上皮细胞数显著下降 ,而嗜酸性粒细胞数和(或 )中性粒细胞数显著升高 ,淋巴细胞与正常对照仍无明显差别 ;当病情缓解时 ,脱落上皮细胞的数量接近正常对照 ,嗜酸性粒细胞和 (或 )中性粒细胞数也显著下降 ,而淋巴细胞明显增多。结论　上皮细胞脱落可能与哮喘急性发作有关 ;嗜酸性粒细胞或中性粒细胞除造成上皮细胞脱落外 ,可能还发挥促上皮细胞再生的有益作用 ,有助于病情的恢复 ;淋巴细胞可能在维持哮喘慢性气道炎症中发挥作用。

Cell profile changes in sputum in the course of asthma in children

Objective To investigate the change of sputum cells in different phases of asthma in children.Methods Sputum was obtained from 25 children with asthma in the exacerbation,improvement and remission stages by using ultrasonically nebulized hypertonic saline or spontaneous expectoration.Sputum was induced in 10 healthy children as control.Sputum was processed and cytospin was examined for a differential cell count with Wright's stain.Results In the initial stage,sputum epithelial cell increased dramatically;as symptom improved,sputum epithelial cell decreased rapidly,but sputum eosinophil and/or neutrophil elevated;in remissiom stage,the number of sputum epithelial cell was near to control's,and sputum eosinophil and/or neutrophil decreased markedly,but sputum lymphocyte increased.Conclusion The desquamation of epithelial cells may trigger the acute inflammation.Eosinophil or neutrophil may have other function except for damaging epithelial cell;lymphocyte may play a role in maintaining chronic inflammation.