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为探索儿童反复呼吸道感染(RRTI)与下呼吸道粘膜纤毛结构异常的关系 ,以及RRTI患儿下呼吸道粘膜纤毛结构异常的发生率 ,并比较原发性和继发性纤毛异常的不同超微结构表现 ,对符合RRTI诊断标准住院患儿进行支气管粘膜活检 ,电镜观察其纤毛超微结构。结果显示 ,47例RRTIs患儿中支气管纤毛柱状上皮细胞结构异常38例(80.9%) ,其中22例(46.8%)为纤毛超微结构异常 ,16例(34.1%)为早期鳞状上皮化生 ;支气管粘膜结构正常9例 (19.1% )。结合临床 ,11例(23.4%)初步诊断为原发纤毛运动障碍 ,其中2例为Kartagener综合征 ;27例(57.4%)诊断为继发性纤毛上皮结构损害。在观察到的8种纤毛超微结构异常表现中 ,原发性和继发性患儿的发生率存在一定差别 ,但无显著统计学差异(P>0.05)。提示下呼吸道纤毛结构异常是儿童RRTIs的病因之一 ,约半数患儿存在支气管纤毛结构异常 ;在RRTIs患儿中大多数纤毛上皮细胞损伤为继发性 ,但RRTIs患儿中原发纤毛运动障碍发病率明显高于人群发病率
To explore the relationship between respiratory recurrent respiratory tract infection (RRTI) and mucosal cilia structural abnormalities in the lower respiratory tract and the incidence of mucociliary structural abnormalities in the lower respiratory tract in children with RRTI and to compare the different ultrastructural manifestations of primary and secondary ciliary abnormalities , Bronchial mucosal biopsies were performed on infants with RRTI diagnostic criteria and their cilia ultrastructure was observed by electron microscopy. The results showed that the structural abnormalities of bronchial ciliated columnar epithelium in 47 children with RRTIs were abnormal in 38 cases (80.9%), of which 22 cases (46.8%) were ciliated ultrastructural abnormalities and 16 cases (34.1%) were early squamous metaplasia ; Bronchial mucosa in normal structure in 9 cases (19.1%). Combined with clinical, 11 cases (23.4%) were initially diagnosed as primary ciliary dyskinesia, of which 2 cases were Kartagener’s syndrome and 27 cases (57.4%) were diagnosed as secondary ciliated epithelial damage. Among the observed abnormalities in the ultrastructure of 8 cilia, there was a difference in the incidence of primary and secondary children, but there was no significant difference (P> 0.05). Suggest that the lower respiratory tract cilia structural abnormalities is one of the causes of RRTIs in children, about half of children with bronchial cilia structural abnormalities; most of the ciliary epithelial cell injury in RRTIs children as secondary, but in children with RRTIs primary ciliary dyskinesia The incidence was significantly higher than the incidence of the crowd