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目的探讨气道炎症指标对支气管哮喘(简称哮喘)患者病情监测及治疗的意义。方法收集2004年1月至2006年1月在北京大学第三医院呼吸科门诊就诊的近半年来未使用口服或吸入激素治疗的哮喘患者87例。进行哮喘症状评分、肺功能检查、诱导痰上清液检测白介素-8(IL-8)浓度及嗜酸粒细胞阳离子蛋白(ECP)浓度,对所有患者病情分级状况和气道炎症指标进行分析,探讨病情严重程度与气道炎症之间的关系;分析急性发作与气道炎症之间的关系。结果(1)重度哮喘患者中性粒细胞、IL-8水平较轻中度患者明显增高;(2)急性发作期患者嗜酸性粒细胞(EOS)、ECP较缓解期明显增高;(3)中性粒细胞与第1秒用力呼气量(FEV1)呈负相关(r=-0.522,P<0.05);中性粒细胞与IL-8呈正相关(r=0.832,P<0.05);(4)ECP、EOS与FEV1、症状评分均无相关性(r=-0.209,r=-0.189,P均>0.05;r=-0.289,r=-0.229,P均>0.05);ECP与EOS呈正相关(r=0.852,P<0.01);(5)中性粒细胞对重度哮喘的阳性预测值为91%,EOS对哮喘急性发作的阳性预测值为92.5%,ECP对哮喘急性发作的阳性预测值98.5%。结论(1)中性粒细胞、IL-8与病情严重程度有关,重度哮喘患者中性粒细胞、IL-8明显增高;(2)ECP、EOS与哮喘的急性发作有关,急性发作期哮喘患者ECP、EOS明显增高;(3)气道炎症指标可用于监测哮喘病情和调整哮喘治疗。
Objective To investigate the significance of airway inflammation in the monitoring and treatment of patients with bronchial asthma (asthma). Methods A total of 87 asthmatic patients without oral or inhaled corticosteroids were collected from January 2004 to January 2006 in the Department of Respiratory Department of Peking University Third Hospital. Asthma symptom scores, pulmonary function tests, induced sputum supernatant IL-8 and eosinophilic protein (ECP) concentrations were detected, and the severity of the disease and airway inflammation were analyzed in all patients The severity of the disease and the relationship between airway inflammation; analysis of the relationship between acute attacks and airway inflammation. Results (1) The levels of neutrophil and IL-8 in patients with severe asthma were significantly higher than those in patients with moderate or severe asthma; (2) The levels of eosinophils (EOS) and ECP in patients with acute exacerbation were significantly higher than those in patients in remission Neutrophil was positively correlated with IL-8 (r = 0.832, P <0.05); (4) There was a negative correlation between PMN and FEV1 (r = -0.522, ) ECP, EOS and FEV1 had no correlation with symptom scores (r = -0.209, r = -0.189, P> 0.05; r = -0.289, r = -0.229, P all> 0.05) (r = 0.852, P <0.01). (5) The positive predictive value of neutrophils to severe asthma was 91%, and the positive predictive value of EOS to acute asthma attack was 92.5%. The positive predictive value of ECP for acute asthma attack 98.5%. Conclusions (1) Neutrophils and IL-8 are associated with the severity of the disease. Neutrophils and IL-8 are significantly increased in patients with severe asthma. (2) ECP and EOS are related to the acute attack of asthma. Patients with acute exacerbation of asthma ECP, EOS was significantly higher; (3) indicators of airway inflammation can be used to monitor the asthma and adjust asthma treatment.