异物吸入患儿呼吸道中性粒细胞活化及蛋白酶的平衡状况

Airway Neutrophil Activation and Protease Imbalance in Airway of Children with Foreign-Body Aspiration

目的观察异物吸入后呼吸道局部中性粒细胞数量及其中性粒细胞弹性蛋白酶(NE)系统的平衡情况。方法对33例异物吸入患儿及22例肺炎患儿肺泡灌洗液(BALF)经Wright-Giemsa染色进行细胞学分析,采用细胞免疫组织化学法测定α1-抗胰蛋白酶(α1-AT)表达,采用ELISA法检测上清液中NE水平和弹性蛋白酶抑制力(EIC)。结果异物组、对侧组、肺炎组中性粒细胞百分比、NE水平及α1-AT的表达均无明显差异(Pa>0.05),但均显著高于对照组(Pa<0.05)。异物组、对侧组、肺炎组游离NE的比例分别为30.3%、27.3%、22.7%。结论异物吸入后呼吸道局部存在与细菌性肺炎类似的炎症反应,并有蛋白酶系统失衡,对侧呼吸道存在同样变化。

Objective To observe neutrophil activation and protease imbalance in airway of children after foreign-body aspiration（FBA）.Methods Bronchoalveolar lavage fluid（BALF） was obtained through fiberoptic bronchoscopy.The supernatant was assayed for the concentration of neutrophil elastase（NE） using enzyme-linked immunosorbent assay（ELISA） and elastase inhibition capacity（EIC）/free elastase activity using a colorimetric assay.The cell pellet were smeared for the expression of α1-antitrypsin（α1-AT） using cellular immunohisto-chemistry and cytologic analysis by Wright-Giemsa stain.Results Percentage of neutrophil,concentration of NE and the expression of α1-AT in BLAF group,pair group and pneumonia group significantly increased compared with that of control group（Pa〈0.05）,which had no significant difference compared with each other（Pa〉0.05）.The ratio of Lib NE in FBA,par and peumcria group was 30.3%,27.3% and 22.7%.Conclusions FBA induces similar airway neutrophil activation and protease imbalance to bacterial pneumonia.The contralateral airway showes the same change as the foreign body side.