诱导痰嗜酸粒细胞与慢性持续期支气管哮喘病情严重程度的关系

Relationship between bronchial asthma severity and eosinophil percentage of induced sputum

目的观察初诊不同病情严重程度慢性持续期支气管哮喘（简称哮喘）患者的诱导痰嗜酸粒细胞（eosinophil，EOS）比例变化，探讨二者之间的关系，并分析诱导痰EOS比例与肺功能的相关性。方法收集专科门诊就诊的63例初诊慢性持续期哮喘患者，根据症状分为轻度持续、中度持续、重度持续3组，分别予诱导痰和肺功能检查。观察不同病情严重程度的患者气道炎症状况。对所得数据用SPSS15．O软件分析，各组间总体分析采用Kruskal—Wallis法，两组间分析采用Mann—WhitneyUtest法。结果①慢性持续期患者诱导痰EOS比例随病情严重程度增加呈增高趋势，重度持续患者诱导痰EOS比例显著高于轻度持续患者（41．8％VS17．8％，P-0．033），但轻度持续与中度持续、中度持续与重度持续患者之间比较诱导痰EOS比例差异无统计学意义（P〉O．05）；②诱导痰EOS比例与第1秒用力呼气容积差异无统计学意义（r=-0．111，P〉0．05），与第1秒用力呼气容积／用力肺活量（％）差异无统计学意义（r=-0．154，P〉0．05）。结论慢性持续期哮喘患者病情严重程度与诱导痰EOS比例有关，但症状不能完全反映气道炎症程度。评价哮喘患者的严重程度时应结合临床症状和气道炎症程度综合考虑。

Objective The eosinophil percentage of induced sputum was observed in persistent asthmatics with different severity, stable stages, and assessed its relationship with lung function. Methods The 63 patients with persistent asthma were recruited from clinic. The range of disease severity was classified into mild, moderate and severe persistent according to Global Initiative for Asthma. Sputum was induced by hypertonic saline aerosol inhalation,and lung function was performed in all patients. All of the data were had analyses by SPSS 15.0. Data among groups were compared by Kruskal-Wallis test, Mann- Whitney U test was used for the comparison between two groups. The correlation between eosinophil counting and lung function was assessed by Spearman rank-order method. Results （3） There were progressively increasing percentage of eosinophils in sputum which related to asthma severity in persistent steroid-naive asthmatic patients. The percentage of eosinophils in sputum from severe asthmatics were significantly higher than mild asthmatics （41.8% vs 17.8%, P =0.033）. However, there was no significant difference between mild and moderate, nor moderate and severe asmatics. （2） In the mild, moderate and severe asthmatics group, percentage of eosinophils in sputum was neither correlated with FEV1 （ r = - 0.111, P 〉 0.05）, nor correlated with FEV1 / FVC （ r = - 0.154, P 〉 0.05 ）. Conclusions There was higher percentage of eosinophils in sputum in servere persist asthmatics. However, disease severity could not reflect the airway inflammation accurately.