76例哮喘儿童气道炎症表型分析

76例哮喘儿童气道炎症表型分析
姚彤;郭红;陈若华
【期刊名称】《新疆医科大学学报》
【年(卷),期】2018(041)002
【摘要】目的研究支气管哮喘(哮喘)患儿的气道炎症表型分布,分析不同气道炎症
表型的炎症标志物与肺功能的特征.方法回顾性分析新疆自治区人民医院儿科
2016年1月-2016年12月期间就诊的76例初诊哮喘患儿的临床资料,按照肺功
能情况分为肺功能正常组(27例)和异常组(49例).分析肺功能正常哮喘患儿和肺功
能异常哮喘患儿的气道炎症表型分布,痰细胞学、呼出气一氧化氮和肺功能的特征.
结果 76例初诊哮喘患儿的气道炎症表型分布为嗜酸粒细胞型占51.3％(39/76),混合细胞型占28.9％(22/76),寡细胞型占10.5％(8/76),中性粒细胞型占9.2％(7/76);肺功能正常组的炎症表型构成比分别为嗜酸粒细胞型22.2％、混合细胞型44.4％、寡细胞型29.6％、中性粒细胞型3.7％;肺功能异常组的炎症表型构成比分别为嗜
酸粒细胞型67.3％、混合细胞型20.4％、寡细胞型0％、中性粒细胞型12.2％.肺功能异常组患儿痰嗜酸性粒细胞水平为(27.9±l9.2)％,高于肺功能正常组的
(6.2±6.1)％,差异有统计学意义(t=-14.23,P＜0.05);肺功能异常组呼出气一氧化氮
浓度为(40.0±14.9)×109 mol/L,高于肺功能正常组呼出气一氧化氮浓度
(21.3±9.2)×109 mol/L,差异有统计学意义(t=-7.8,P＜0.05).肺功能异常组中性粒
细胞型患儿的第一秒用力呼气容积(FEV1)占预计值(75.7±8.5)％、用力肺活量(FVC)占预计值(79.3±3.1)％、一秒率(FEV1/FVC)实测值占预计值(77.0±8.9)％,低于其他炎症表型患儿,且其呼出气一氧化氮(FeNO)低于嗜酸性粒细胞型及混合细胞型(P＜0.05).结论哮喘患儿气道炎症表型包括嗜酸性粒细胞型、混合细胞型、中性
粒细胞型及寡细胞型,其中嗜酸性粒细胞型最常见,中性粒细胞型所占比例最低;肺功能异常组中仍以嗜酸性粒细胞型最多,中性粒细胞型与嗜酸粒细胞型的肺功能损害均显著.%Objective To study the phenotype distribution of airway inflammation in ethnic group children with bronchial asthma and to analyze the characteristics of inflammatory markers and pulmonary function in different airway inflammatory phenotypes.Methods A retrospective analysis was made on the clinical data of 76 cases of newly diagnosed asthma in ethnic group children in Xinjiang Uyghur Autonomous Region People's Hospital from January 2016 to December 2016.According to the pulmonary function,all cases were divided into normal pulmonary function group (27 cases) and abnormal group (49 cases).The characteristic of airway inflammation phenotype distribution,sputum cytology,Exhaled nitric oxide in asthmatic children with normal and abnormal pulmonary function was analyzed.Results The distribution of Airway inflammatory phenotype:eosinophilic 51.3％
(39/76),mixed cell type 28.9％ (22/76),oligo cell type 10.5％
(8/76),neutrophil type 9.2％ (7/76);the phenotype distribution in normal pulmonary function group:eosinophilic 22.2％,mixed cell type 44.4％,oligo cell type 29.6％,neutrophil type 3.7％;in abnormal pulmonary function group:eosinophilic 67.3％,mixed cell type 20.4％,oligo cell type
0％,neutrophil type 12.2 ％.Sputum eosinophil level of abnormal pulmonar y function group (27.9 ± 19.2 ％) is higher than that of the normal pulmonary function group (6.2±6.1％).Moreover,the difference was statistically significant (P ＜0.05);Exhaled nitric oxide in abnormal
pulmonary function group (40±14.9) ppb is higher than th e normal pulmonary function group (21.3± 9.2) ppb,similarly,the difference was statistically significant (t =-7.8,P ＜0.05).The FEV％(75.7±8.5)％,FVC％(79.3±3.1)％,FEV1/FVC％(77±8.9)％ in abnormal pulmonary function group with neutrophil type,were lower than those of other inflammatory phenotype of children (P ＜0.05),and the FeNO was lower than that of eosinophilic cell type and mixed cell type (P ＜0.05).Conclusion The airway inflammation of asthma children's phenotype include
eosinophils,neutrophils,mixed cell type and few cell type,the most common type is eosinophil,neutrophil is rare;in abnormal pulmonary function group:eosinophils is the most type and the most significant impairment of pulmonary function were neutrophil cell type and eosinophilic cell type.
【总页数】6页(P153-157,165)
【作者】姚彤;郭红;陈若华
【作者单位】海军军医大学附属长海医院儿科,上海200433;新疆维吾尔自治区人民医院儿科,乌鲁木齐830000;海军军医大学附属长海医院儿科,上海200433;新疆维吾尔自治区人民医院儿科,乌鲁木齐830000
【正文语种】中文
【中图分类】R725.6
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