四种常见呼吸系统疾病患者诱导痰中炎性细胞计数变化及临床意义

Changes of induced sputum cell counts in four common respiratory diseases and clinical significance

目的研究常见四种呼吸系统疾病患者发作期和缓解期诱导痰中炎性细胞计数变化,探讨其临床意义。方法选取2014年6月至2015年5月,内蒙古自治区人民医院呼吸内科45例支气管哮喘患者(I组),115例慢性阻塞性肺疾病患者(COPD,II组),40例肺炎患者(III组),30例慢性支气管炎患者(IV组)发作期和缓解期,采用诱导痰液沉渣涂片法检测组中中性粒细胞、嗜酸粒细胞、巨噬细胞、淋巴细胞百分比,并分析比较。结果哮喘发作期组诱导痰中,嗜酸性粒细胞的比例较对照组明显升高(P﹤0.05)。哮喘缓解期组诱导痰中,嗜酸性粒细胞的比例较对照组明显升高(P﹤0.05)。哮喘发作期组诱导痰中,嗜酸性粒细胞的比例较哮喘缓解期组明显升高(P﹤0.05)。COPD发作期组诱导痰中,中性粒细胞、嗜酸性粒细胞的比例较对照组明显升高(P﹤0.05)。COPD缓解期组诱导痰中,中性粒细胞的比例较对照组明显升高(P﹤0.05)。COPD发作期组诱导痰中,中性粒细胞、嗜酸性粒细胞的比例较COPD缓解期组明显升高(P﹤0.05)。肺炎、支气管炎发作期组诱导痰中,中性粒细胞的比例较对照组明显升高(P﹤0.05)。肺炎、支气管炎缓解期组诱导痰中,中性粒细胞的比例较对照组明显升高(P﹤0.05)。肺炎、支气管炎发作期组诱导痰中,中性粒细胞的比例较缓解期组明显升高(P﹤0.05)。结论诱导痰技术将会成为一种常规检查,为更多呼吸系统疾病提供更快捷、便利、准确的诊断和治疗依据。

Objective To analyze the changes of induced sputum cell counts in four common respiratory diseases in the stage of attack and remission, and the clinical significance. Methods From June in 2014 to May in 2015, 115 cases with chronic obstructive pulmonary disease were chosen as group I, 45 cases with bronchial asthma were chosen as group II, 40 cases with pneumonia were chosen as group III, 30 cases with chronic bronchitis were chosen as group IV. Using induced sputum sediment smears, the percentages of inflammatory cells such as neutrophils, eosinophil cells, macrophages, lymphocytes in the stage of attack and remission were comparatively analyzed. Results During the onset of asthma attacks, the proportion of eosinophils was significantly higher than that of the control group（P﹤0.05）; the proportion of eosinophils in the asthma remission stage group was significantly higher than that in the control group（P﹤0.05）; The proportion of eosinophils in the asthma episode induced sputum was significantly higher than that in asthma remission stage（P﹤0.05）. The proportions of neutrophils and eosinophils were significantly higher than that of the control group during the COPD episode induced sputum（P﹤0.05）; the proportion of neutrophils in the COPD remission stage group was significantly higher than that in the control group（P﹤0.05）; the proportion of neutrophils and eosinophils was significantly higher than that of COPD remission stage in the COPD attack group（P﹤0.05）. The proportion of neutrophils in the sputum of patients with pneumonia and bronchitis was significantly higher than that in the control group（P﹤0.05）; the proportion of neutrophils in the remission stage induced by pneumonia and bronchitis was significantly higher than that in control group（P﹤0.05）; the proportion of neutrophils in the sputum of patients with pneumonia and bronchitis was significantly higher than that in the remission stage（P﹤0.05）. Conclusion These results suggest that the induced sputum technology will become a routine examination for more respiratory diseases, and provide more convenient and accurate diagnosis and treatment basis.