支气管哮喘患者血清嗜酸细胞阳离子蛋白的变化

Clinical sigificance of serum eosinophil cationic protein in patients with bronchial asthma

目的探讨检测血清嗜酸细胞阳离子蛋白(ECP)在支气管哮喘的诊断、病情监测及疗效判断中的价值。方法采用荧光酶免疫法(FEIA)测定了发作期和缓解期哮喘患者各20例 ,慢性阻塞性肺疾病(COPD)患者16例和正常人20例的血清ECP ,同时进行了肺功能测定(FEV1占预计值的百分比) ,并对发作期哮喘患者在给予吸入皮质激素治疗3mo后复测其ECP及肺功能。结果发作期哮喘患者治疗前血清ECP的水平明显地高于缓解期哮喘患者、COPD患者和正常人(P<0.01);缓解期哮喘患者血清ECP的水平亦高于COPD组和正常人(分别为P<0.05和P<0.01) ,而3组患者的肺功能则无明显差异。发作期哮喘患者经抗炎治疗3mo后 ,其血清ECP的水平明显下降(P<0.01),通气功能改善 ,两者呈负相关趋势(r=0.735 ,P<0.05)。结论血清ECP的水平可客观而较直接地反映气道炎症的程度 ,预测疾病的发作。因此 ,动态检测血清ECP的水平 ,可准确地判断气道炎症的控制情况 ,更有效地评价抗炎治疗的效果。

Aim To explore the role of serum eosinophil cationic protein(ECP) in the diagnosis, monitoring and curative effect assessment of asthma. Methods Serum ECP level was detected with Pharmacia CAP system in 20 severe asthma patients, 20 stable asthmatic patients, 16 patients with chronic obstructive pulmonary disease(COPD) and 20 normal individuals. At the same time their lung function(FEV1%) was also detected. In the first group after inhaled steroid treatment for three months their serum ECP level and FEV1%were redetected. Results Before the treatment, serum ECP levels in severe asthma patients were significantly higher than those in stable asthma patients,COPD and normal individuals(P<0.01), and serum ECP in stable asthma patients were also higher than those in COPD group and in normal individuals (P<0.05 and P<0.01). But there was no significant difference of lung function among three groups. After anti inflammation treatment, serum ECP level in severe asthma patient was significantly decreased, and lung function also was improved, with negative correlation(r=0.735, P<0.05). Conclusion Serum ECP level could directly reflect airway inflammatory degree and help predicting the asthma exacerbation and its severity. Kinetic measurement of serum ECP level could instruct controlled status of airway inflammation. Also could more effectively assess the efficacy of anti inflammatory treatment.