诱导痰嗜酸性粒细胞阳离子蛋白对支气管哮喘的诊断价值

The Effect of Induced Eosinophil cationic protein of sputum in the diagnosis of bronchial asthma

目的:通过检测支气管激发试验阳性患者诱导痰中嗜酸性粒细胞阳离子蛋白(ECP)水平,探讨ECP对哮喘的诊断价值。方法:选取呼吸内科以咳嗽3周以上就诊的患者,共300例,进行支气管激发试验检查。通过ELISA法检测所有支气管激发试验阳性患者诱导痰的ECP水平,根据最后追踪最终确诊为哮喘的患者,用ROC曲线统计分析得出哮喘患者ECP水平与激发试验阳性的临界值。结果:激发试验阳性患者最后确诊为哮喘组的ECP水平为226.6±30.8μg/L,激发试验阳性患者非哮喘组ECP水平为61.0±22.2μg/L,2组比较有极显著性差异(P<0.01);诱导痰ECP水平对支气管哮喘诊断的最佳临界值为186.05μg/L,该切点的灵敏度为0.938,特异度0.895,Youden指数0.833。结论:ECP水平能作为气道高反应诊断的评价指标,有助于对支气管哮喘的诊断以及鉴别诊断。

Objective ：To explore the sputum ECP concentration levels in diagnosis of asthma on the basis of bronchial provocation test positive. Methods：300 patients which coughed more than 3 weeks in Department were selected and had provocation test with pulmonary function exameiation. The patients with bronchial provocation test positive detected by ELISA were induced sputum eosinophil cationic protein. Obtainned ECP levels and thresholds concentration of positive provocation test by statistical analysis of ROC curve in patients with asthma. Results ： ECP levels in the asthma group of provocation test positive were 226.6±30.8 μg/L, ECP levels in no asthmatic group of provocation test positive was 61.0±22.2 μg/L （P 〈 0.01 ）. The best critical value of induced sputum ECP concentration for the diagnosis of bronchial asthma was 186.05 μg/L, the sensitivity of cut - off point was 0. 938, specificity was 0. 895, Youden index was 0. 833. Conclusion： ECP levels can be used to diagnose airway hyperresponsiveness as the evaluation index, and contribute to bronchial asthma diagnosis and differential diagnosis.