诱导痰细胞学分析对咳嗽变异型哮喘的诊断价值

目的:分析和评价咳嗽变异型哮喘患者痰细胞学特点及其临床意义。方法:对63例符合慢性咳嗽诊断标准的咳嗽变异型哮喘(CVA组,31例)以及慢性支气管炎急性发作患者(AECOPD组,32例)进行气道反应性测定、痰液诱导及诱导痰细胞学分类,并测定诱导痰上清液中嗜酸性粒细胞阳离子蛋白(ECP)。结果:咳嗽变异型哮喘组诱导痰嗜酸性粒细胞(0.186±0.163)×109/L、中性粒细胞(0.401±0.279)×109/L、ECP为(2.93±2.01)mg/L。慢性支气管炎急性发作组诱导痰嗜酸性粒细胞(0.012±0.005)×109/L、中性粒细胞(0.555±0.288)×109/L、ECP为(0.36±0.28)mg/L。上述3个指标在两组间比较有显著性差异(P<0.05)。结论:咳嗽变异型哮喘表现为痰嗜酸性粒细胞活化为主的多细胞炎症,痰嗜酸性粒细胞咳嗽变异型哮喘气道炎症中有较重要的作用,诱导痰细胞学分析对咳嗽变异型哮喘具有较好的诊断价值。

Exploration of the Clinical Value of Induced Sputum Cells Analysis in Patients with Cough Variant Asthma

Objective: To evaluate the characteristics and significance of induced sputum cells analysis in patients with cough variant asthma.Methods: Sixty-three cases with chronic cough,of which,31 with cough variant asthma(group A) and 32 with AECOPD(group B) were determined through airway reaction test,sputum inducing and cells counting,and the assaying of eosinophil cationic protein(ECP).Results: The eosinophil and neutrophil cells counting and ECP level in group A were higher than in group B [(0.186±0.163)×109/L,(0.401±0.279)×109/L and(2.93±2.01) mg/L,versus(0.012±0.005)×109/L,(0.555±0.288)×109/L and(0.36±.28) mg/L,respectively,all P<0.05].Conclusion: The active eosinophils are the primary inflammation cells in cough variant asthma patients and the analysis of induced sputum cells has an important diagnostic role in patients with chronic cough.