诱导痰液分析在咳嗽变异性哮喘诊断中的应用(1)
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【摘要】目的 探讨诱导痰液分析在咳嗽变异性哮喘(CVA)中的临床应用价值。方法 选取我院2007年9月至2009年8月79例变异性哮喘患者，采用超声雾化吸入3%～5%的高渗盐水进行诱导排痰，对其痰液进行嗜酸性粒细胞(EOS)百分率、肥大细胞(MC)百分率、中性粒细胞(N)及嗜酸性粒细胞阳离子蛋白(ECP)等检测，同时对1s用力呼气容积 (FEV1)及1s用力呼气占预计值的百分比(FEV1占预计值% )进行测定。结果 其中有35例被临床诊断为患有CVA，患者的痰液中MC、EC百分率、ECP浓度、FEV1及FEV1占预计值 %与对照组比较，均具有显著差异性 (P<0.05 )，而与典型支气管哮喘组的比较则无显著差异性 (P>0.05 )。在进行抗炎治疗之后患者的咳嗽症状很快得到缓解，对痰液中MC、EC百分率、ECP浓度、FEV1及FEV1占预计值 %作出复测，结果与治疗前比较，差异有显著性。结论 通过痰液分析，从实验室角度阐明CVA存在气道炎症，为其诊断和治疗均提供了一项可靠的评价指标。
【关键词】诱导痰液分析 咳嗽变异性哮喘(CVA) 临床应用价值
中图分类号：R562.25文献标识码：A文章编号：1005-0515(2011)8-021-02
【Abstract】Objective To investigate the induced sputum analysis in cough variant asthma (CVA) in the clinical application. Methods Our hospital from September 2007 to August 2009 79 cases of variant asthma patients, the use of ultrasonic inhalation of 3% to 5% hypertonic saline induced sputum, sputum eosinophils of its cells ( EOS) percentage of mast cells (MC) percentage of neutrophils (N) and eosinophil cationic protein (ECP) and other testing, while forced expiratory volume in 1s (FEV1) and forced expiratory 1s percentage of predicted value percentage (FEV1% predicted) were measured. Results of which 35 cases were clinically diagnosed as suffering from CVA, the patient's sputum MC, EC percentage, ECP concentrations, FEV1 and FEV1% predicted compared with the control group, were significant differences (P <0 .0 5 ), with a typical comparison of bronchial asthma group there was no significant difference (P> 0 .0 5). During the anti-inflammatory treatment in patients with cough soon after to ease of sputum MC, EC percentage, ECP concentrations, FEV1 and FEV1% predicted to retest the results compared with before treatment, the difference was significant. Conclusion Sputum analysis, CVA from the laboratory point of view there is clear airway inflammation, its diagnosis and treatment are provided a reliable evaluation.
【Key words】 induced sputum analysis cough variant asthma (CVA) clinical value
咳嗽变异性哮喘(Cough Varian T asthma CVA)的常见典型临床表现呈持续的咳嗽。嗜酸性粒细胞(EOS)是产生哮喘气道炎症反应的重要细胞因子，也是衡量咳嗽变异性哮喘病情严重程度的首要指标[1]。文章通过对79例变异性哮喘患者诱导痰液进行嗜酸性粒细胞(EOS)百分率、肥大细胞(MC)百分率、中性粒细胞(N)及嗜酸性粒细胞阳离子蛋白(ECP)等检测 ......
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