诱导痰炎性标志物检测在判定哮喘严重程度和鉴别诊断中的应用

Use of inflammatory markers in induced sputum in asthma severity and differential diagnosis

目的探讨哮喘患者诱导痰中嗜酸性粒细胞(Eos)和嗜酸细胞阳离子蛋白(ECP)与其哮喘严重程度的关系及鉴别诊断价值。方法选择武汉大学人民医院2002-07~2004-06的门诊哮喘患者59例,检测其肺功能并分别采用瑞氏染色及荧光免疫法检测高渗盐水诱导痰中Eos数量和ECP质量浓度。选择同期20例慢性阻塞性肺疾病患者和10名健康人作为对照。结果哮喘患者诱导痰中Eos数量与患者第1秒用力呼气容积/用力肺活量(FEV1%)呈显著负相关(r=-0·65,P<0·01);ECP质量浓度与患者FEV1%呈显著负相关(r=-0·59,P<0·01)。随病情加重哮喘患者诱导痰中Eos数量和ECP质量浓度逐渐升高,且轻度、中度和重度患者之间比较差异有统计学意义(P<0·05)。哮喘患者诱导痰中Eos数量和ECP质量浓度显著高于慢性阻塞性肺疾病组和健康组(P<0·01)。结论诱导痰中Eos和ECP质量浓度可了解哮喘的严重程度,并有助于与慢性阻塞性肺疾病的鉴别。

Objective To investigate the relationship between the number of eosinophil （Eos） and level of eosinophil cationic protein （ECP） in induced sputum and asthma severity and their value of differential diagnosis. Methods From July 2002 to June 2004, 59 asthmatic patients were selected in the People Ilospital of Wuhan University. The number of eosinophil and lew^l of ECP were measured by Wrights＇ stain and lmmuno - CAP System. The lung function was also eval- uated. The same index was measured in 20 patients with COPD and 10 healthy subjects as control. Results The number of eosinophil in induced sputum in asthmatic patients negatively correlated with FEV, % （r = -0, 65, P 〈0, 01 ）, The level of ECP also negatiw＇~ly enrrelated with FEV, % （r = -0, 59, P 〈 0. 01 ） . The number of eosiuophil and the level of ECP in induced sputurn between mild asthma and moderate asthma and severe asthma were statistically significant （P〈0. 05） , The number of eosinophil and level of ECP in asthma group were significantly higher than those of COPD group and heahhy group （P〈0. 01 ） . Conclusion The levels of eosinophil and ECP in induced sputum may indicate asthma severity and they can be helpful to the differential diagnosis between asthmatic and COPD.