对头孢抗生素过敏的哮喘患者嗜酸性粒细胞特点与临床意义

Cephalosporin antibiotics for patients with allergic asthma characterized by eosinophilsand clinical significance

目的观察对头孢抗生素过敏的哮喘患者的嗜酸性粒细胞（EOS）变化特点与临床意义。方法收集对头孢抗生素过敏的哮喘患者19例（过敏组），与无明确过敏史的哮喘患者21例（非过敏组）作为对比，观察其血常规、免疫球蛋白的变化及痰液EOS的含量。结果过敏组的外周血EOS计数、百分率及痰液EOS均明显高于非过敏组（P〈0．05）但两组的中性粒细胞及淋巴细胞的计数及百分率均无统计学差异。两组的IgG及IgA含量比较差异无显著性（P〉0．05），且均在正常参考范围内。两组患者的IgE均高于参考值，且过敏组的IgE明显高于非过敏组（P〈0．05）。相关性分析显示外周血EOS绝对值及百分数，以及痰液EOS计数，均与血清IgE含量呈正相关性（分别为r=0．612，P=0．021；r=0．726，P=0．018；r=0．823，P=0．016）。结论嗜酸性粒细胞及血清IgE在头孢抗生素过敏的哮喘患者的发病机制当中起到重要作用。

Objective To observe the cephalosporin antibiotics in patients with allergic asthma, eosinophils （EOS） changes in the characteristics and clinical significance. Methods 19 patients with allergic asthma （allergic group） to eephalosporin antibiotics, with no clear history of allergic asthma were chosen, 21 patients （non-allergic group） as compared to observe the blood routine examination changes in immunoglobulin levels and sputum EOS.Results The results of peripheral blood EOS count allergic group, the percentage of sputum EOS and non-allergic group were significantly higher （P= 0.031, P= 0. 026, P = 0.018）; but there were neutrophil and lymphocyte count and percentage. There was no significant difference. IgG and IgA of two groups showed no significant difference （P= 0.096, P= 0.179）, and within the normal reference range. Patients in both groups were higher than the reference value of IgE, and IgE allergic group was significantly higher than that of non-allergic group, hut allergy （P= 0.020）. Correlation analysis showed that the absolute value and percentage of peripheral blood EOS and EOS sputum counts and serum IgE levels were positively correlated （respectively r = 0.612, P= 0.021; r = 0.726, P= 0.018; r = 0.823, P = 0.016）. Conclusions Eosinophils and serum IgE play an important role in allergic asthma cephalosporin antibiotics in the pathogenesis.