【摘要】 目的:探讨嗜酸粒细胞和嗜酸粒细胞阳离子蛋白(ECP)在气道高反应性患者诊断中的价值。方法:378名慢性咳嗽和/或胸闷病人作激发试验,激发试验阳性者作进一步的检查,包括血清嗜酸粒细胞、痰液嗜酸粒细胞和ECP。排除其它疾病后,这些病人被拟诊为支气管哮喘,根据GINA方案进行规范治疗,并追踪24个月。结果:83名患者诊断为哮喘,25名诊断为非哮喘,哮喘患者血清嗜酸细胞计数为(4.8±3.5)%,明显高于非哮喘患者[(1.2±2.1)%,P<0.01]。哮喘患者痰液中的嗜酸细胞计数、ECP分别为[(9.4±3.2)和(289.4±112.3)μg/L],明显高于非哮喘患者[(2.1±1.3)%和(57.7±18.7)μg/L,P<0.01]。痰液中的嗜酸细胞计数和ECP诊断哮喘的结果和追踪结果一致性较高,而血清嗜酸细胞计数为中度一致性。结论:痰液中的嗜酸细胞、ECP对哮喘的诊断和鉴别诊断有重要的帮助。更多还原

【Abstract】 Objective: To determine the diagnostic value of eosinophil count and eosinophil cationic protein(ECP) in the patients with chronic cough and/or chest tightness and airway hyperresponsiveness(AHR).Methods: A total of 378 subjects with mild respiratory symptoms were screened through methacholine challenge test(MCT) and the patients with positive MCT were further studied and followed up.They underwent further laboratory studies,including serum eosinophil count,sputum eosinophil count,and sputum ECP analysis.All the patients with AHR were considered suspected diagnosed asthma and were systematic treated according to GINA.A final diagnosis of asthma was made by reactivity to therapy and 24 months’ follow-up.Results: Of all the 112 positive subjects,83 subjects(74.1%) were diagnosed as asthma and 25(22.3%) subjects were considered non-asthmatics.Serum eosinophil count of the asthma patients was different from that of the non-asthma patients([4.8±3.5]% vs [1.2±2.1]%,P<0.01);the eosinophil count and ECP of induced sputum in non-asthma group were(2.1±1.3)% and 57.7±18.7 μg/L,respectively,which were lower than those in subjects with asthma(9.4±3.2 and 289.4±112.3 μg/L,respectively,both P<0.01).The concordance of eosinophil count and ECP of induced sputum was high in the diagnosis of asthma.Conclusion: The sputum eosinophils,ECP and serum eosinophils are important indicators in diagnosing for asthma.更多还原