喘息婴幼儿鼻咽分泌物嗜酸粒细胞与血清特异性IgE的关系分析

The association of eosinophils in nasapharyngeal secretion and serum IgE in wheezing infants

目的探讨婴幼儿喘息时鼻咽分泌物涂片中嗜酸粒细胞计数及与血清特异性IgE的关系。方法选择2002-2004年收治的1个月～3岁的喘息及支气管肺炎患儿223例,分为3组,其中反复喘息(包括婴幼儿哮喘和喘息发作≥2次)组76例,毛细支气管炎组65例,支气管肺炎(无喘息症状)组82例。吸取鼻咽分泌物1ml进行嗜酸粒细胞计数,并测定血清特异性IgE的水平。结果反复喘息组鼻咽分泌物嗜酸粒细胞计数明显高于其他两组,差异有统计学意义(P=0.000);反复喘息组血清食物变应原(fx5E)的阳性检出率及吸入性变应原(Phadiatop)阳性检出率均明显高于其他两组,差异有统计学意义(P=0.000),毛支组和支气管肺炎组之间差异则无统计学意义;血清特异性IgE与鼻咽分泌物嗜酸粒细胞计数之间存在显著正相关;鼻咽分泌物嗜酸粒细胞水平在同时存在喘息和特应性的患儿最高,在既没有喘息也无个人特应性的患儿最低,有喘息或血清IgE一项者介于两组之间。结论鼻咽分泌物嗜酸粒细胞计数方法操作简单、无创、快速,费用低,且能在一定程度上反映哮喘的病理特征,与血清特异性IgE之间呈正相关,可以在临床进一步推广应用。

Objectives To investigate the relationship between eosinophil level in nasopharyngeal secretions and specific serum IgE level in wheezing infants. Methods Three groups of infants had been enrolled, infants with recurrent wheezing （n = 76）; infants with bronchiolitis （n = 65）; and infants with common pneumonia （n = 82）. The eosinophil level in nasopharyngeal secretions and specific serum IgE level were measured. The results were analyzed among three groups. Results The eosinophil level in nasopharyngeal secretions in the recurrent wheezing group infants were significantly higher than that in bronchiolitis group and common pneumonia group （P = 0.000） ; the positive ratio of Phadiatop and fx5E was the highest in recurrent group, which was significantly different from other two groups （P = 0.000）： there was a positive correlation between eosinophil level in nasopharyngeal secretions and specific serum IgE level; the eosinophil level in nasopharyngeal secretions was higher in infants with wheezing and atopy than those without wheezing and atopy. Conclusions It is easier, quicker, and less costly to measure the eosinophil level in nasopharyngeal secretions. The level reflects the inflammation of asthma and has a correlation with specific serum IgE level.However, more research is needed.