CAJ | 학술논문

目的观察感染后咳嗽(post infection cough,PIC)患儿气道分泌物神经肽变化,探讨其在该症发病机制中的作用及临床意义.方法选择PIC患儿52例作为PIC组,另选择30例支气管肺炎患儿作为肺炎组,观察两组痰细胞分类及P物质(SP)、神经激肽A(NKA)、神经激肽B(NKB)和降钙素基因相关肽(CGRP)浓度在治疗前后的变化.结果两组痰细胞分类比较:肺炎组抗感染治疗前中性粒细胞、巨噬细胞、淋巴细胞较PIC组明显升高(P＜0.05)；抗感染治疗后肺炎组中性粒细胞、巨噬细胞、淋巴细胞明显下降(P ＜0.01)；PIC组治疗前后痰细胞分类无明显变化(P＞0.05)；治疗后两组痰细胞分类比较差异无统计学意义(P＞0.05)；两组嗜酸性粒细胞治疗过程中无明显变化(P＞0.05).两组神经源性炎症介质比较:PIC组抗感染治疗前SP和CGRP分别为(538.4 ±432.2)ng/L、(123.6 ±70.2)ng/L,肺炎组分别为(613.2 ±345) ng/L、(156.2±82.6)ng/L,差异无统计学意义(P＞0.05)；抗感染治疗后PIC组SP和CGRP分别为(552.8 ±421.7) ng/L、(133.5 ±81.3) ng/L,与治疗前对比无明显变化(P＞0.05)；抗感染治疗后肺炎组SP和CGRP明显下降,分别为(156.2±131.2) ng/L、(741.2±35.4) ng/L(P＜0.01)；治疗后两组SP和CGRP浓度存在显著差异(P ＜0.01)；NKA和NKB在治疗前后无明显变化.结论 SP和CGRP介导的气道神经源性炎症参与气道的急性和慢性感染过程,PIC患儿伴随SP和CGRP的持续升高,提示其与PIC的发病密切相关,SP和CGRP可作为早期检测感染后慢性咳嗽的参考指标.
목적 관찰감염후해수(post infection cough,PIC)환인기도분비물신경태변화,탐토기재해증발병궤제중적작용급림상의의.방법 선택PIC환인52례작위PIC조,령선택30례지기관폐염환인작위폐염조,관찰량조담세포분류급P물질(SP)、신경격태A(NKA)、신경격태B(NKB)화강개소기인상관태(CGRP)농도재치료전후적변화.결과 량조담세포분류비교:폐염조항감염치료전중성립세포、거서세포、림파세포교PIC조명현승고(P＜0.05)；항감염치료후폐염조중성립세포、거서세포、림파세포명현하강(P ＜0.01)；PIC조치료전후담세포분류무명현변화(P＞0.05)；치료후량조담세포분류비교차이무통계학의의(P＞0.05)；량조기산성립세포치료과정중무명현변화(P＞0.05).량조신경원성염증개질비교:PIC조항감염치료전SP화CGRP분별위(538.4 ±432.2)ng/L、(123.6 ±70.2)ng/L,폐염조분별위(613.2 ±345) ng/L、(156.2±82.6)ng/L,차이무통계학의의(P＞0.05)；항감염치료후PIC조SP화CGRP분별위(552.8 ±421.7) ng/L、(133.5 ±81.3) ng/L,여치료전대비무명현변화(P＞0.05)；항감염치료후폐염조SP화CGRP명현하강,분별위(156.2±131.2) ng/L、(741.2±35.4) ng/L(P＜0.01)；치료후량조SP화CGRP농도존재현저차이(P ＜0.01)；NKA화NKB재치료전후무명현변화.결론 SP화CGRP개도적기도신경원성염증삼여기도적급성화만성감염과정,PIC환인반수SP화CGRP적지속승고,제시기여PIC적발병밀절상관,SP화CGRP가작위조기검측감염후만성해수적삼고지표.
Objective To observe the change of neuropeptide of the infant patients with post infection cough (PIC) and explore the possible pathogenesis and diagnostic value.Methods Fifty-two cases with PIC in our hospital were selected as PIC group,while thirty infant patients with bronchopneumonia as pneumonia group.Phlegm cells classification and substance P(S P),neurokinin(NKA),neurokinin (NKB),calcitonin gene-related peptide (CGRP) concentration of the patients in both groups were compared.Results Phlegm cells classification of the two groups showed that,compared with the PIC group,the neutrophils,macrophages,and lymphocytes of the infant patients in the pneumonia group were obviously higher (P ＜ 0.05).After anti-infection treatment,the neutrophils,macrophages and lymphocytes of the infant patients in the pneumonia group were obviously lower(P ＜ 0.01).The phlegm cells classification of the PIC group had not changed significantly before and after treatment (P ＞ 0.05).After treatment,the phlegm cells classification of both groups had no significant difference (P ＞ 0.05).During the progress of treatment,there was no evident change for the eosinophils (P ＞ 0.05).Neuropeptide of the two groups showed that,before treatment,the SP and CGRP of the patients in the PIC group were (538.4 ±432.2) ng/L,(123.6 ±70.2) ng/L,and that in the pneumonia group were (613.2 ± 345) ng/L,(156.2 ± 82.6) ng/L.There was no significant difference (P ＞ 0.05).After treatment,the SP and CGRP of the PIC group were (552.8 ± 421.7) ng/L,(133.5 ± 81.3) ng/L,and there was no significant difference (P ＞0.05).While the SP and CGRP of the patients in the pneumonia group were (156.2 ± 131.2) ng/L,(741.2 ± 35.4) ng/L,they were obviously lower (P ＜ 0.01).There was statistical difference compared with the PIC group after treatment (P ＜ 0.01).The NKA and NKB had not changed significantly before and after treatment.Conclusion Airway neurogenic inflammation mediated SP and CGRP plays a key role in the acute and chronic infections.The increase of SP and CGRP is closely related to the morbidity of PIC.So SP and CGRP is a reference index for early detection of PIC.