CAJ | 학술논문

目的观察胃食管反流源性"哮喘"的气道炎症特点.方法筛选34例胃食管反流(GERD)伴"类哮喘"症状患者,并以12例哮喘无GERD患者和11例健康正常人为对照组,结合诱导痰方法,刘氏染色分析痰液中细胞分类,应用酶联免疫吸附法(ELISA)测定痰上清液中的IL-5,6和8的浓度.结果 GERDa组与哮喘组比较,中性粒细胞百分率明显增高(P＜0.05),嗜酸性细胞百分率减低(P＜0.05);GERD组及哮喘组IL-5(52.86±20.25,55.69±17.72,70.56±12.63),IL-6水平(22.14±9.18,18.62±9.94,15.63±13.61)较健康正常组均升高(P＜0.05),其中哮喘组IL-5水平明显高于GERD a组(P＜0.05).相较于正常组(143.26±32.71),GERD组IL-8水平(308.33±178.60,234.28±130.98)升高(P＜0.05),而哮喘组(179.78±51.08)与正常组比较,IL-8水平差异无统计学意义(P＞0.05).结论 GERD源性"哮喘"气道炎症是以中性粒细胞浸润和IL-8升高为主要特点,不同于哮喘以嗜酸性细胞浸润、IL-5升高为主的气道炎症状态,当合并哮喘时,GERD可通过上述细胞因子的作用促进哮喘既有的气道炎症,进而加重其病程.
목적 관찰위식관반류원성"효천"적기도염증특점.방법 사선34례위식관반류(GERD)반"류효천"증상환자,병이12례효천무GERD환자화11례건강정상인위대조조,결합유도담방법,류씨염색분석담액중세포분류,응용매련면역흡부법(ELISA)측정담상청액중적IL-5,6화8적농도.결과 GERDa조여효천조비교,중성립세포백분솔명현증고(P＜0.05),기산성세포백분솔감저(P＜0.05);GERD조급효천조IL-5(52.86±20.25,55.69±17.72,70.56±12.63),IL-6수평(22.14±9.18,18.62±9.94,15.63±13.61)교건강정상조균승고(P＜0.05),기중효천조IL-5수평명현고우GERD a조(P＜0.05).상교우정상조(143.26±32.71),GERD조IL-8수평(308.33±178.60,234.28±130.98)승고(P＜0.05),이효천조(179.78±51.08)여정상조비교,IL-8수평차이무통계학의의(P＞0.05).결론 GERD원성"효천"기도염증시이중성립세포침윤화IL-8승고위주요특점,불동우효천이기산성세포침윤、IL-5승고위주적기도염증상태,당합병효천시,GERD가통과상술세포인자적작용촉진효천기유적기도염증,진이가중기병정.
Objective To observe the feature of airway inflammation in patients troubled by gastro-oesophageal reflux (GER) with asthma-like symptoms. Methods Thirty-four cases of GER with asthma symptoms, 12 with asthma and 11 healthy subjects were enrolled in this study. Sputum was induced by hypertonic saline aerosol inhalation in all patients and healthy subjects, and the sputum differential cell counts were determined. The concentration of IL-8, -6, and -5 in the supernatant of induced sputum was measured by using enzyme linked immunosorbert assay (ELISA) respectively. Results The sputum eosinophilic percentage in GERDa patients was significantly decreased (P ＜0. 05 ) and the sputum neutrophil percentage was increased as compared with those in asthmatic patients ( P ＜ 0. 05 ). The concentrations of IL-5 (52.86 ±20.25, 55.69 ± 17.72, 70.56 ± 12.63), IL-6 (22. 14 ±9. 18, 18.62 ±9.94, 15.63 ±13.61 ) in the sputum supernatant in all patients were significantly increased as compared with healthy controls (P ＜ 0. 05), and the concentration of IL-5 in asthmatic patients were higher than in GERDa patients (P ＜0. 05). The concentration of IL-8 in GERD patients (308. 33 ± 178.60, 234. 28 ± 130. 98) was significantly increase as compared with healthy controls ( 143.26 ± 32.71, P ＜ 0. 05 ). There was no significant difference in the concentration of IL-8 between asthmatic patients and healthy controls ( P ＞ 0. 05 ).Conclusion Asthma and gastroesophageal reflux are both characterized by airway inflammation. Differed with asthma obtained by airway eosinophilic inflammation and mainly elevated IL-5, the GER-triggered airway inflammation is characterized by a neutrophilic airway inflammation and mainly enhanced levels of IL-8. GER does aggravate pre-existing airway inflammation in asthmatic patients through related cytokines which is the linkage between them.