不同分期支气管哮喘肺功能、嗜酸粒细胞的不同表达

不同分期支气管哮喘肺功能、嗜酸粒细胞的

不同表达

［摘要］目的观察哮喘患者急性发作期、缓解期的肺功能和血嗜酸粒细胞(EOS)的变化，探讨其临床意义。方法对57例急性发作期哮喘患者做肺功能测定和取外周血进行EOS的计数，经治疗后选取符合缓解期标准的患者50例，也做肺功能测定和外周血EOS的计数，比较两期患者肺功能及EOS测定结果。FEV1/FVC比值≥70%为肺功能正常，50%及25%用力肺活量时呼气流速(V50、V25)实测值/预测值＜70%为小气道功能异常。结果急性发作期哮喘患者外周血EOS明显高于缓解期组(P＜0.01)，急性发作期患者肺功能FEV1明显低于缓解期，差异有显著性(P＜0.05)。V50、V25在急性发作期与缓解期相比较均差异无显著性(P＞0.05)。EOS与FEV1、V50、V25呈显著负相关(P＜0.05)。结论外周血EOS在哮喘急性发作时明显增加，提示EOS是反映气道炎症程度的可靠指标。反映小气道功能的V50、V25在急性发作期与缓解期变化不大，多数患者在缓解期仍存在小气道功能异常，提示缓解期气道炎症仍持续存在，需要做长期的维持治疗。

［关键词］哮喘；嗜酸粒细胞；肺功能；气道炎症；急性发作期；缓解期

Lung function and eosinophil varied reflect on different period of bronchia asthma

［Abstract］ Objective We explore the clinic usage according to observing the change of lung-functions and eosinophil (EOS) between the acute-outbreak period and catabatic period of asthma sufferers.Methods Choosing 57acute-outbreak asthma sufferers，then checking out the lung-functions and taking the EOS count of peripheral blood.Choosing 50 patients that met the standard of catabatic period after treatment.We also survey the lung-function and the EOS count of peripheral blood of the 50 paring with the data of two groups.If FEV1/FVC≥70%，normal;if the velocity of flow of 50% and 25% vital capacity (V50、V25) fact/predict＜70%，symbolizing small trachea functions abnormal.Results The peripheral blood’s EOS of acute-outbreak period group is obviously higher than the catabatic period group’s (P＜0.01).The lung-function of acute-outbreak group is obviously lower than the catabatic group’s (P＜0.05).There is little difference between V50 and V25 no matter in acute-outbreak period or catabatic period (P ＞0.05).EOS and FEV1、V50 and V25 are minus related.Conclusion The peripheral blood’s EOS increases when asthma breakouts.The EOS is a reliable signal that reflects the grades of trachea inflammation.V50 and V25 which represent the functions of small

trachea don

’t change much in both the two periods.Majority of the patients still have abnormal small trachea symptoms which is a signal reflecting the trachea inflammation and need a continuously treatment.

［Key words］asthma;eosinophil;lung-function;trachea inflammation ; acute-outbreak period;catabatic period

支气管哮喘是多种细胞和细胞组份参与的慢性气道炎症性疾患［1］。研究发现，粒—巨噬细胞集落刺激因子通过调节多种细胞特别是嗜酸粒细胞(EOS)的活化、黏附和趋化等活性过程［2］，在气道炎症的发生和发展中持续发挥重要的作用。肺功能测定在哮喘的诊断、疗效评估等方面具有重要作用。通过测定哮喘患者两期状态中的EOS水平及肺功能的改变，探索其关系，旨在为临床监测哮喘气道炎症变化提供新的观察指标，并着重评价支气管哮喘缓解期小气道状态及变化情况，为临床合理应用抗炎药提供依据。

1 资料与方法

1.1 一般资料选择2003年2月～2004年8月在我院呼吸内科住院的哮喘患者，入选患者均符合1997年中华医学会制订的《支气管哮喘防治指南》诊断标准，并参照2003年修订方案。缓解期判断标准：

经过治疗或未经治疗症状、体征消失，并维持4周以上。急性发作期57例(急性发作组)，男25例，女32例，平均年龄40.5岁。入院治疗后达到缓解期标准者，收集患者50例(缓解组)，男22例，女28例，平均年龄39岁。