哮喘患者的气道炎症表型及临床特征研究

Study on Airway Inflammation Phenotypes and Clinical Features in Asthmatic Patients

【目的】分析哮喘患者的气道炎症表型分布及其临床特征。【方法】选取2012年1月至2015年8月本院收治的417例支气管哮喘患者为研究对象，其中，43例患者符合重症哮喘标准，374例为普通哮喘。比较不同程度哮喘患者的气道炎症分型、呼出气一氧化氮（FeNO）测定和肺功能特征。【结果】①两组患者的年龄、体质量指数（BMI）和诱导痰嗜中性粒细胞比较差异无统计学意义（P〉0．05）。两组的一秒用力呼气容积（FEV1）／用力肺活量（FVC），诱导痰嗜酸粒细胞和FeNO比较，差异有统计学意义（P〈0．05）。②两组的不同表型构成比较，差异无统计学意义（P〉0．05），表型排序均为：嗜酸粒细胞型、混合细胞型、嗜中性粒细胞型、寡细胞型。③重症哮喘不同气道炎症表型的哮喘患者，FeNO、FEV1／FVC（％）和FEV1均具有统计学意义（P〈0．05），嗜中性粒细胞型是肺功能损害最严重的重症哮喘表型。【结论】嗜酸性粒细胞型是哮喘最常见的气道炎症表型，在重症哮喘患者中，嗜中性粒细胞型的肺功能最差。

[Objective]To analyze the airway inflammation phenotypes and clinical features of severe asthma compared to mild-moderate （＂common＂） asthma. [Methods]A total of 417 cases of asthma were retrospectively analyzed in our hospital from January 2012 to August 2015. Out of these, 43 patients were classified as the severe asthma group, and 374 patients as the common asthma group. All patients received induced sputum cell counts and pulmonary function tests, and all received fractional exhaled nitric oxide （FENO） tests. The airway inflammation phenotypes were defined and the clinical features of patients with severe asthma were studied. [Results]（1）Age, BMI, weight, and induced sputum neutrophil of the two groups had no statistical significance （ P 〉0.05）. Differences in FEV1/FVC, induced sputum acidophilic granulocyte and FENO of the two groups were statistically significant （ P 〈0.05）. （2） There were no differences between the severe asthma group and the common asthma group in the distributions （ P 〉0.05）. The distribution of airway inflammation phenotypes of asthma was as follows., eosinophilic subtype, mixed granulocytic subtype, neutrophilic subtype, and paucigranulocytic subtype. （3） FENO, FEV1/FVC（%） and FEV1 had significant statistical difference （ P 〈0.05） in severe asthmatic patients with different airway inflammatory phenotypes, and the neutrophil type was the most severe type of severe asthma with lung function damage. [Conclusion]Eosinophilic subtype is the most common airway inflammatory phenotypes of asthma. Neutrophilic subtype may be the most intractable subtype with severely damaged pulmonary function in severe asthma.