哮喘患者外周血EOS计数、血清ECP、GM-CSF浓度检测及临床意义

目的　寻找一种低创、简捷的监测方法判断哮喘的气道炎症及指导哮喘的治疗。方法　选择 41例哮喘患者根据临床特征 (过敏史、家族史、季节性、过敏性鼻炎等 )及个别患者的常见过敏原皮内试验结果分为变应性哮喘组(AA 18例 )及非变应性哮喘组 (NA 2 3例 ) ,同时选择 2 0例正常对照组 ,分别监测他们治疗前后外周血嗜酸性粒细胞(EOS)计数、嗜酸性粒细胞阳离子蛋白 (ECP)、粒细胞 -巨噬细胞集落刺激因子 (GM -CSF)的含量 ,并进行治疗前后症状的评分。结果　AA组治疗前后比较及与正常对照组比较EOS计数、ECP浓度差异有显著性意义 (P <0 .0 5 )。NA组治疗前后比较及与正常对照组比较EOS计数、ECP浓度差异无显著性意义 (P >0 .0 5 )。AA组和NA组血清GM -CSF浓度治疗前后比较及与正常对照组比较差异无显著性意义 (P >0 .0 5 )。但两组患者治疗前后症状积分明显改善 (P <0 .0 1)。AA组治疗前后ECP含量与症状积分之间没有明显的直线相关关系 (P >0 .0 5 )。结论　EOS计数、ECP浓度可以作为AA组气道炎症的判断指标 ,对于NA组则不敏感。NA组EOS变化呈现“先低后高” ,其原因可能是GM -CSF等EOS刺激因子在外周造血器官部位的相对高浓度所致。哮喘的治疗应根据炎症指标配合肺功能监测调整治疗方案 ,不能单以症状的改善

Measuring to peripheral blood EOS courting, serum ECP, GM - CSF density of bronchial asthma and analysis of its clinical significance

Objective Finding a sort of hypoimpairable, convenient method to judge airway inflammation of asthma and guide its treatment.Methods Peripheral blood eosinophil (EOS) counting, serum eosinophil cationic protein(ECP) and granulocyte macrophage colony stimulating factor(GM CSF) concentration were monitored in 41 asthmatic patients before and after treatment and 20 controls. 41 asthmatic patients were divided into 2 groups: allergic asthma(AA 18 patients), nonallergic asthma(NA 23 patients) according to clinical features(family history, allergy history, seasonal feature, allergic rhinitis, et al.) and common sensitinogen skin test carried out in a few patients. At the same time, symptom scores were assessed before and after treatment.Results Peripheral blood EOS counting? serum ECP density before and after treatment in AA group were found statistical significant difference( P <0.05) and it was also found between AA group and controls. Whereas, the same result didn't occur in NA group ( P >0.05). In AA and NA group, serum GM-CSF concentration before and after treatment was not found difference ( P >0.05),and as it was compared with controls, the difference was not also significant ( P >0.05). But, to the above 2 groups, symptoms scores were inspected statistically decreased( P <0.01). Before and after treatment, no significant correlations were shown between symptoms scores and ECP density.Conclusions We can judge airway inflammatison of asthma in the light of peripheral blood EOS counting? serum ECP concentration in AA group. But in NA group. it was not sensitive. In NA group, EOS fluctuated from low to high, its cause may be the relative high concentration in peripheral blood making organs of GM CSF and other EOS stimulating factors. Treatment of asthma should be adjusted on the basis of pulmonary function and inflammatory quotas, its criteria can't only be symptoms relief.