摘要
目的探寻难治性哮喘支气管肺泡灌洗液(bronchoalveo larlavage fluid,BALF)细胞分类及气道病原菌定植、感染的状况。方法选择符合标准的难治性哮喘住院患者138例,通过支气管镜肺泡灌洗,对其进行BALF细胞分类及细菌培养检测。结果①BALF炎症细胞分类:中性粒细胞63.78±30.02,嗜酸粒细胞2.70±4.04,淋巴细胞5.93±6.48,肺泡巨噬细胞27.21±31.87,显示中性粒细胞明显增高。②病原菌对气道炎症的影响:病原菌阳性患者中性粒细胞均值较病原菌阴性患者有所增加,但差异无统计学意义,嗜酸粒细胞均值较病原菌阴性的患者低,差异具有统计学意义,P<0.01。③BALF炎症细胞分类:按气道炎症分类标准,138例患者中嗜酸粒细胞性哮喘24例,占17.38%;中性粒细胞性哮喘46例,占33.33%,少粒细胞性哮喘26例,占18.84%,混合粒细胞性哮喘42例,占30.43%。各组一般状况比较,中性粒细胞组及寡细胞组病程长、年龄大、皮质醇低,且吸烟者比例在中性粒细胞组较高。④各炎症类型既往治疗状况:中性粒细胞组使用全身激素的患者比例高于嗜酸粒细胞组,而使用吸入激素的患者比例低于嗜酸粒细胞组。⑤病原学检测结果:138例患者中检出病原菌者23例,占16.7%,其中以革兰阴性杆菌居多,共计16例,占病原菌检出总数的69.6%。结论①难治性哮喘患者气道炎症细胞存在着特殊的炎症表型,其以中性粒细胞增多为主,其原因可能与细菌感染和定植、激素使用、吸烟、年龄、病程等有关。②呼吸道细菌感染和定植在难治性哮喘的发病中具有一定的作用。
Objective To seek the cytological classification and airway pathogenic bacteria colonization, infection situation of bronchoalveolar lavage fluid (BALF) in patients with refractory asthma.Methods Select 138 inpatients with refractory asthma which measure upto national standard,to test the BALF cells classification and bacterial culture through the bronchoscope alveolar lavage.Results ①The inflammatory cells classification of BALF:Neutrophile granulocyte 63.78±30.02,Eosinophilic granulocyte 2.70±4.04, Lymphocyte 5.93±6.48,Alveolarmacrophages 27.21±31.87,display neutrophils increased obviously.②Influence of pathogens on airway inflammation:the mean value of Neutrophils in patients with positive pathogens are an increase compared with patients with negative, but no statistically significant differences, Eosinophils mean value are low compared wiht patients with negative,the differences was statically significant(P<0.01).③The inflammatory cells classification of BALF:Classification standard by airway inflammation,138 cases of 24 cases of all the 138 cases are Eosinophil asthma, account for17.38%,46 cases with Neutrophilic asthma, account for 33.33%,26 cases of Myeloid less asthma, 18.84%, 42 case with Mixed-grain cell asthma, 30.43%. General status in the group, Neutrophils group and few cell group have a longer course of disease,older ages,lower cortisol,smoking rateis higher in Neutrophils group.④Previous treatment condition of each inflammation type:patients in Neutrophils groupwith used much more systemic hormones are higher than the Eosinophils group, while the volume of inhaled steroids used less than eosinophils group.⑤Etiology test results:23 cases of pathogenic bacteria were checked out in 138 patients, account for 16.7%, Gram-negative bacilli isolated from most of them, a total of 16 cases, percent of total pathogen detection 69.6%.Conclusions ①There is a special table types of airway inflammation cells in patients with refractory asthma,dominated by Neutrophils ncreased type, the reason for
出处
《中华哮喘杂志（电子版）》
CAS
2013年第3期15-19,共5页
Chinese Journal of Asthma(Electronic Version)
关键词
难治性哮喘
支气管肺泡灌洗液
细胞分类
病原菌
Refractory asthma
Bronchoalveolar lavage fluid
Cytological classification
Pathogens
