中华儿科杂志
中華兒科雜誌
중화인과잡지
Chinese Journal of Pediatrics
2012年
7期
525-530
,共6页
陈德晖%钟帼钰%罗炜%陈桥丽%陈如冲%林育能%潘小安%李瑾瑛%吴上志%赖克方%钟南山
陳德暉%鐘幗鈺%囉煒%陳橋麗%陳如遲%林育能%潘小安%李瑾瑛%吳上誌%賴剋方%鐘南山
진덕휘%종귁옥%라위%진교려%진여충%림육능%반소안%리근영%오상지%뢰극방%종남산
诱导痰%细胞学分类%参考值%儿童
誘導痰%細胞學分類%參攷值%兒童
유도담%세포학분류%삼고치%인동
Induced sputum%Cytological categorization%Normal values%Child
目的 初步建立广州地区5～15岁正常儿童高渗盐水诱导细胞学方法学及细胞分类正常参考值范围.方法 选择2010年1-12月广州市中小学正常体检年龄5～15岁的儿童352名,所有儿童均经问卷调查,医生详细询问病史及体格检查,进行肺功能及呼气峰流速(PEF)检查,剔除不符合标准儿童后,实际入选儿童266名,其中男137名,女129名,用5％高渗盐水超声雾化吸人15～ 30 min,每10分钟嘱儿童用力咯痰至培养皿,若无痰或痰量不足则继续雾化,30 min后仍无痰则视为失败,终止诱导程序.选取痰液中取出不透明和密度较高的痰液进行诱导痰液细胞分类检测.此研究经医院医学伦理委员会批准,并由监护人签署知情同意书.结果 入选人群中成功诱导痰液175名(175/266,占65.8％),其中16名儿童痰标本不合格,91名诱导不成功,共失败107名( 107/266,40.2％),实际取得合格痰标本159名,诱导成功率59.8％ (159/266).159名正常儿童诱导痰液细胞分类均呈偏态分布,淋巴细胞中位数为0.012,四分位数间距(IQR)0.020,95％可信区间(95％CI)0.015 ～0.022;中性粒细胞中位数0.207,IQRO.330,95％CI0.266～0.356；单核细胞中位数为0.761,IQR0.327,95％ CI0.607～0.699;嗜酸性粒细胞中位数0.004,IQR 0.019,95％CI 0.013～0.022,各细胞分类结果以单核细胞及中性粒细胞为主.诱导痰细胞分类值与性别、年龄无关,不受被动吸烟影响(P均＞0.05).诱导过程中,不良事件发生率为4.4％( 7/159),所发生的不良事件症状轻微,无需用药物缓解不适.诱导成功组与诱导失败组诱导后PEF％下降率差异无统计学意义(P＞0.05).结论 在国内首次初步建立较大样本的本地区正常儿童诱导痰液细胞学检查的方法及细胞学分类的正常参考值范围.
目的 初步建立廣州地區5～15歲正常兒童高滲鹽水誘導細胞學方法學及細胞分類正常參攷值範圍.方法 選擇2010年1-12月廣州市中小學正常體檢年齡5～15歲的兒童352名,所有兒童均經問捲調查,醫生詳細詢問病史及體格檢查,進行肺功能及呼氣峰流速(PEF)檢查,剔除不符閤標準兒童後,實際入選兒童266名,其中男137名,女129名,用5％高滲鹽水超聲霧化吸人15～ 30 min,每10分鐘囑兒童用力咯痰至培養皿,若無痰或痰量不足則繼續霧化,30 min後仍無痰則視為失敗,終止誘導程序.選取痰液中取齣不透明和密度較高的痰液進行誘導痰液細胞分類檢測.此研究經醫院醫學倫理委員會批準,併由鑑護人籤署知情同意書.結果 入選人群中成功誘導痰液175名(175/266,佔65.8％),其中16名兒童痰標本不閤格,91名誘導不成功,共失敗107名( 107/266,40.2％),實際取得閤格痰標本159名,誘導成功率59.8％ (159/266).159名正常兒童誘導痰液細胞分類均呈偏態分佈,淋巴細胞中位數為0.012,四分位數間距(IQR)0.020,95％可信區間(95％CI)0.015 ～0.022;中性粒細胞中位數0.207,IQRO.330,95％CI0.266～0.356；單覈細胞中位數為0.761,IQR0.327,95％ CI0.607～0.699;嗜痠性粒細胞中位數0.004,IQR 0.019,95％CI 0.013～0.022,各細胞分類結果以單覈細胞及中性粒細胞為主.誘導痰細胞分類值與性彆、年齡無關,不受被動吸煙影響(P均＞0.05).誘導過程中,不良事件髮生率為4.4％( 7/159),所髮生的不良事件癥狀輕微,無需用藥物緩解不適.誘導成功組與誘導失敗組誘導後PEF％下降率差異無統計學意義(P＞0.05).結論 在國內首次初步建立較大樣本的本地區正常兒童誘導痰液細胞學檢查的方法及細胞學分類的正常參攷值範圍.
목적 초보건립엄주지구5～15세정상인동고삼염수유도세포학방법학급세포분류정상삼고치범위.방법 선택2010년1-12월엄주시중소학정상체검년령5～15세적인동352명,소유인동균경문권조사,의생상세순문병사급체격검사,진행폐공능급호기봉류속(PEF)검사,척제불부합표준인동후,실제입선인동266명,기중남137명,녀129명,용5％고삼염수초성무화흡인15～ 30 min,매10분종촉인동용력각담지배양명,약무담혹담량불족칙계속무화,30 min후잉무담칙시위실패,종지유도정서.선취담액중취출불투명화밀도교고적담액진행유도담액세포분류검측.차연구경의원의학윤리위원회비준,병유감호인첨서지정동의서.결과 입선인군중성공유도담액175명(175/266,점65.8％),기중16명인동담표본불합격,91명유도불성공,공실패107명( 107/266,40.2％),실제취득합격담표본159명,유도성공솔59.8％ (159/266).159명정상인동유도담액세포분류균정편태분포,림파세포중위수위0.012,사분위수간거(IQR)0.020,95％가신구간(95％CI)0.015 ～0.022;중성립세포중위수0.207,IQRO.330,95％CI0.266～0.356；단핵세포중위수위0.761,IQR0.327,95％ CI0.607～0.699;기산성립세포중위수0.004,IQR 0.019,95％CI 0.013～0.022,각세포분류결과이단핵세포급중성립세포위주.유도담세포분류치여성별、년령무관,불수피동흡연영향(P균＞0.05).유도과정중,불량사건발생솔위4.4％( 7/159),소발생적불량사건증상경미,무수용약물완해불괄.유도성공조여유도실패조유도후PEF％하강솔차이무통계학의의(P＞0.05).결론 재국내수차초보건립교대양본적본지구정상인동유도담액세포학검사적방법급세포학분류적정상삼고치범위.
Objective To establish the method of cytological examination and the normal reference values for hypertonic saline solution-induced sputum of healthy children (age range from 5 to 15 years ) with physical examination in Guangzhou.Method A total of 352 children,5 to 15 years old,were enrolled from primary school and middle school in Guangzhou from January to December,2010.All subjects completed a standardized questionnaire on the presence of respiratory,allergic symptoms and family history,the medical history and the physical examination was performed by doctors,lung function (forced expiratory volume at 1 s in predicted normal,FEV1 ％ ) was determined.There were 266 healthy children (137 males,129 females) who were selected and undergone hypertonic saline solution induction of sputum,and cytological examination was performed. Hypertonic saline ( 5％ ) was nebulized and inhaled for 15 - 30 min. No expectoration within 30 min was defined as failure,and the procedure was terminated.The part of opaque and higher density sputum samples was detected by cytology.The proportion of neutrophils,lymphocytes,eosinophils,macrophages and monocytes was calculated.This study was approved by the institutional Ethics Review Committee of First Affiliated Hospital of Guangzhou Medical College.Informed consent was obtained from the legal guardians of all participants following a detailed description of the purpose and potential benefits of the study.Result There were 175 subjects' induced sputum specimens ( 175/266,65.8％ ),non-qualified sputum samples were obtained from 16 of the subjects.The proportions of median (IQR) of lymphocytes were 0.012(0.020),95％ CI were ranged from 0.015 to 0.022 ;neutrophils 0.207 (0.330),95％ CI 0.266 -0.356 macrophages 0.761 (0.327 ),95 ％ CI 0.607 -0.699; eosinophils 0.004 (0.019),95％ CI 0.013 -0.022.There were no significant differences in proportions of cytological findings of female or male,different age groups and second-hand smoking or not ( all P ＞ 0.05 ).The incidence of adverse event was 4.40％ (7/159).Conclusion The method and the preliminary data may be used for research,diagnosis and treatment of patients with chronic cough and airway inflammation.
