哮喘病人气道粘膜炎症宏观表现与细胞学关系的研究

Relationship between macroscopic evaluation of asthmatic patients airway and mucus cytology

目的：通过分析经纤维支气管镜肉眼观察哮喘病人气道炎症和临床表现以及气道粘膜组织中炎性细胞的关系，以了解肉眼观察哮喘病人气道炎症的特点。方法：采用Dahl肉眼评分系统对受试对象气道炎症进行积分后，钳取气道粘膜组织，利用HE染色结合免疫组化染色方法计数气道粘膜的各种炎性细胞，比较哮喘组与对照组之间差异，分析哮喘病人Dahl计分、气道粘膜炎性细胞计数和临床病情分级之间的关系。结果：①哮喘组Dahl积分为7．35±0．88，明显高于对照组1．06±0．36（P＜0．05），哮喘组Dahl积分与病情程度呈正相关（r＝0．73，P＜0．05）；②哮喘组气道粘膜嗜酸性粒细胞（17．9±23．3）×102／mm2，明显高于对照组（1．9±2．1）×102／mm2（P＜0．05）；哮喘组气道粘膜EG2阳性（活化分泌状态的嗜酸性细胞）细胞数（8．9±9．5）×102／mm2，明显高于对照组（0．8±0．8）×102／mm2，并且EG2阳性细胞数与病情程度相关（r＝0．65，P＜0．05）；③未发现哮喘组Dahl积分与粘膜组织的炎性细胞计数有显著相关性。结论：经纤维支气管镜对哮喘病人气道的肉眼评价是一种宏观视察气道炎症的客观指标，能够准确地反映哮喘病情程度。

AIM: To study the macroscopic charateristic of airway inflammation of asthmatic patients, and the relationship betwee visual aspect and mucosal cytology. METHODS: Afer a visual scoring of aimp inflammation by using Dahl endoscopic scoring system with fiberoptic bronchoscopy, the mucosal biopsies were performed HE histochemical staining and EG2 immunohistochemical staining were used to calculate the inflammational cell. The difference bettween asthmatic group and control group was compared. The relationship between Dahl scoring, iaflammational cell counts of airway mucus, and clinical grades were analyzed. RESULTS: The Dahl Scoring of asthmatic group was 7. 35±0. 88, which was significantly higher than tha of control group 1.60±0.36 (P <0.05). The Dahl scoring from asthmatic group was correlated with the clinical grades (r = 0.73, P < 0.05). The number of eosinophils in airway mucus from asthmatic group was (17.9± 7. 0) ×102/mm2, which was much higher than that of control group (1. 9±1.0)×102/mm2(P < 0.05), and the number of eosinophils in airway mucus from asthmatic group was correlated with clinical grades (r = 0. 65, P <0.05). CONCLUSION: Bronchoscopic visual scoring of asthmatic patients could provide objective macroscopic inflammatory paramter, which might represent a useful indicator of the severity of asthma.