CAJ | 학술논문

目的探寻难治性哮喘支气管肺泡灌洗液(bronchoalveolar lavage 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 ①BALE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:1 38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1 6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.
목적 탐심난치성효천지기관폐포관세액(bronchoalveolar lavage fluid,BALF)세포분류급기도병원균정식、감염적상황.방법 선택부합표준적난치성효천주원환자138례,통과지기관경폐포관세,대기진행BALF세포분류급세균배양검측.결과 ①BALE염증세포분류:중성립세포63.78±30.02,기산립세포2.70±4.04,림파세포5.93±6.48,폐포거서세포27.21±31.87,현시중성립세포명현증고.②병원균대기도염증적영향:병원균양성환자중성립세포균치교병원균음성환자유소증가,단차이무통계학의의,기산립세포균치교병원균음성적환자저,차이구유통계학의의,P ＜0.01.③BALF염증세포분류:안기도염증분류표준,138례환자중기산립세포성효천24례,점17.38％;중성립세포성효천46례,점33.33％,소립세포성효천26례,점18.84％,혼합립세포성효천42례,점30.43％.각조일반상황비교,중성립세포조급과세포조병정장、년령대、피질순저,차흡연자비례재중성립세포조교고.④각염증류형기왕치료상황:중성립세포조사용전신격소적환자비례고우기산립세포조,이사용흡입격소적환자비례저우기산립세포조.⑤병원학검측결과:1 38례환자중검출병원균자23례,점16.7％,기중이혁란음성간균거다,공계1 6례,점병원균검출총수적69,6％.결론 ①난치성효천환자기도염증세포존재착특수적염증표형,기이중성립세포증다위주,기원인가능여세균감염화정식、격소사용、흡연、년령、병정등유관.②호흡도세균감염화정식재난치성효천적발병중구유일정적작용.
Objective To seek the cytological classification and airway pathogenic bacteria colonization,infection situation of bronchoalveolar lavage fluid (BALF) in patients with refractoryasthma.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 ① The 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.② Influence 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).③ The inflammatory cells classification of BALF:Classification standard by airway inflammation,138 cases of 24 cases of all the 138 cases are Eosinophil asthma,account for 17.38％,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 ① There is a special table types of airway inflammation cells in patients with refractory asthma,dominated by Neutrophils ncreased type,the reason for this may be related to bacterial infection and colonization,hormone use,smoking,age,course of disease.②Respiratory tract bacterial infection and colonization has a certain role in the pathogenesis of refractory asthma.