毛细支气管炎患儿鼻咽抽吸物分析对预测反复喘息的意义

目的 探讨鼻咽抽吸物分析对毛细支气管炎患儿反复喘息的预测价值.方法 采集81例毛细支气管炎患儿鼻咽抽吸物,直接免疫荧光法检测病毒抗原,ELISA法测半胱氨酰白三烯(LTD4),并进行白细胞分类计数.随访2年,根据喘息复发次数分为非反复喘息组和反复喘息组,比较两组患儿鼻咽抽吸物的差异.结果 完成随访的75例患儿中,反复喘息者17例,占随访人数的22.67%.非反复喘息和反复喘息患儿的鼻咽抽吸物中,LTD4含量分别为(198.49 ± 91.95)pg/ml和(263.16 ± 113.73)pg/ml,差异有统计学意义(P ＜ 0.05);呼吸道合胞病毒检出率分别为62.07%和64.71%,差异无统计学意义(P ＞ 0.05);细胞分类都以中性粒细胞为主,两组比较差异无统计学意义(P ＞ 0.05).结论 毛细支气管炎患儿鼻咽抽吸物LTD4水平检测可能可以作为预示反复喘息发生的筛选指标之一.

Predictive significance of the nasopharyngeal aspirate analysis of bronchiolitis on recurrent wheeze

Objective To explore predictive value of the nasopharyngeal aspirate(NPA)analysis of bronchiolitis on later recurrent wheeze.Methods The NPA of 81 in-patient infants with bronchiolitis was collected at admission,the viral antigens were detected by direct immunofluorescent assay,the levels of cysteinyl-leukotriene LTD4 were measured by ELISA and the white cells were classified.These patients were divided into recurrent group and non-recurrent group according to frequency of wheezing during 2-year follow-up,and difference of the NPA between two groups was assessed.Results Seventeen of 75(22.67%)followed up children developed recurrent wheezing.LTD4 level was(198.49 ± 91.95)pg/ml and(263.16 ± 113.73)pg/ml in non-recurrent and recurrent group respectively(P < 0.05).Positive respiratory syncytial virus detection rate in non-recurrent group and recurrent group was 62.07% and 64.71% respectively(P > 0.05).Neutrophils was predominant cell type in the NPA,no significant difference between two groups was found(P > 0.05).Conclusions LTD4 level of the NPA from bronchiolitis may be one of the screening indices which predict recurrent wheeze development.