不同时期哮喘患儿诱导痰中炎性细胞计数变化及意义

The changes and significance of inflammatory cell count in the induced sputum from children with different periods of asthma

目的 观察不同时期支气管哮喘患儿诱导痰中炎性细胞的百分比变化,探讨儿童哮喘部分发病机制.方法 收集69例哮喘患儿,按临床症状分为急性发作期组、临床缓解期3个月组和6个月组,于同时间、同群体在该院儿科门诊健康体检儿童中,选取对照组22例,检测各组诱导痰液沉渣涂片中中性粒细胞和嗜酸粒细胞百分比,并分析比较.结果 四组间中性粒细胞百分比比较,急性发作期组比临床缓解期3个月组、临床缓解期6个月组和对照组高[（57.905±11.615）％与（40.137±11.668）％、（33.825±12.457）％、（23.836±13.585）％,P=0.039、0.000、0.000];临床缓解期3个月组及临床缓解期6个月组均高于对照组（P=0.000、0.032）;临床缓解期3个月组与临床缓解期组6个月差异无统计学意义（P=0.538）;急性发作期组嗜酸性粒细胞百分比比临床缓解期3个月组、临床缓解期6个月组和对照组高[（4.090±1.452）％比（2.685±1.190）％、（2.151±1.417）％、（1.848 ±0.887）％,P=0.002、0.000、0.000];临床缓解期3个月组与对照组差异无统计学意义（P=0.937）.结论 支气管哮喘患儿诱导痰液中中性粒细胞百分比和嗜酸性粒细胞百分比在急性发作期显著增高,中性粒细胞及嗜酸性粒细胞可能参与儿童哮喘的部分发病机制.

Objective To study the different periods of childhood bronchial asthma induced sputum of the percentage change of inflammatory cells,and to explore part of the pathogenesis of asthma in children.Methods 69 children with asthma（the age ≥5 years old） were selected.By clinical symptoms,they were divided into acute exacerbation and clinical remission of 3 months and 6 months.At the same time,in the same groups of hospital pediatric clinic,22 healthy children were chosen as control group.The percentage of neutrophils and eosinophils in induced sputum was detected.Through the comparison,we can explore the correlation between the two kinds of inflammatory cells in different periods of asthma.Results Comparing the percentage of neutrophils among the four groups,acute exacerbation group was compared with clinical remission three months group,clinical remission six months group and the normal control group,acute exacerbation group was higher than the clinical remission group of three months,clinical remission of six months and normal control group [（57.905 ± 11.615）% vs （40.137 ± 11.668）%,（33.825 ± 12.457） %,（23.836 ± 13.585） %,P =0.039,0.000,0.000].The clinical remission of three months and clinical remission six months group were higher than the normal control group（P =0.000,0.032）.The clinical remission of three months group and 6 months group had no significant difference （P =0.538）.The percentage of eosinophils in acute exacerbation group was higher than the clinical remission of three months group,clinical remission of six months and normal control group [（4.090 ± 1.452） % vs （2.685 ± 1.190） %,（2.151 ± 1.417） %,（1.848 t 0.887） %,P =0.002,0.000,0.000].The clinical remission of three months group and the normal control group had no significant difference （P =0.937）.Conclusion Asthma in children induced sputum neutrophil percentage and eosinophil percentage are significantly higher in acute exacerbation.The study shows that neutrophils and eosinophils are involved in the part of the pathogenesis of bronchial asthma in children.