诱导痰细胞分类在嗜酸细胞性支气管炎诊断和治疗中的应用

doi:10.3877/cma.j.issn.1674-6902.2020.04.007

中华肺部疾病杂志(电子版) ›› 2020, Vol. 13 ›› Issue (04) : 466 -469. doi: 10.3877/cma.j.issn.1674-6902.2020.04.007

论著

诱导痰细胞分类在嗜酸细胞性支气管炎诊断和治疗中的应用

王斌¹, 胡明冬², 徐静¹, 张椿³^,^†(

), 陈华萍¹^,^†(

), 王关嵩¹, 徐智¹, 李琦¹

^1. 400037　重庆，陆军（第三）军医大学第二附属医院全军呼吸内科研究所
^2. 400037　重庆，陆军（第三）军医大学第二附属医院全军呼吸内科研究所；400037　重庆，陆军（第三）军医大学第二附属医院老年与特勤医学科
^3. 400037　重庆，陆军（第三）军医大学第二附属医院医务处

收稿日期:2020-04-17 出版日期:2020-08-25
通信作者: 张椿, 陈华萍
基金资助:
国家重点研发计划(2017YFC0112702); 陆军军事医学创新工程(18CXZ002); 陆军军医大学第二附属医院临床科研重点项目(2016YLC06)

Effect of induced sputum on diagnosis and treatment of eosinophilic bronchitis

Bin Wang¹, Mingdong Hu², Jing Xu¹, Chun Zhang³^,^†(), Huaping Chen¹^,^†(), Guansong Wang¹, Zhi Xu¹, Qi Li¹

^1. Institute of Respiratory Diseases, Xinqiao Hospital, Army Medical University, Chongqing 400037, China
^2. Institute of Respiratory Diseases, Xinqiao Hospital, Army Medical University, Chongqing 400037, China; Department of Gerontology and Secret Service Medicine, Xinqiao Hospital, Army Medical University, Chongqing 400037, China
^3. Medical Department, Xinqiao Hospital, Army Medical University, Chongqing 400037, China

Received:2020-04-17 Published:2020-08-25
Corresponding author: Chun Zhang, Huaping Chen

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引用本文：

王斌, 胡明冬, 徐静, 张椿, 陈华萍, 王关嵩, 徐智, 李琦. 诱导痰细胞分类在嗜酸细胞性支气管炎诊断和治疗中的应用[J/OL]. 中华肺部疾病杂志(电子版), 2020, 13(04): 466-469.

Bin Wang, Mingdong Hu, Jing Xu, Chun Zhang, Huaping Chen, Guansong Wang, Zhi Xu, Qi Li. Effect of induced sputum on diagnosis and treatment of eosinophilic bronchitis[J/OL]. Chinese Journal of Lung Diseases(Electronic Edition), 2020, 13(04): 466-469.

目的

探索诱导痰细胞分类在嗜酸细胞性支气管炎(EB)诊断和治疗中的作用。

方法

回顾性分析我院门诊239例慢性咳嗽患者，依据慢性咳嗽中诊断标准，分为非EB组和EB组，分析两组诱导痰中细胞分类情况；同时给予EB患者进行8周治疗，观察经治疗后诱导痰中各细胞分类的改变情况。

结果

239例慢性咳嗽患者中，非EB患者216例，占90.7%，EB患者23例，占9.3%，两组中共有121例(50.6%)患者诱导痰中嗜酸细胞百分比升高；非EB患者组细胞总计数为(4.83±2.61)×10⁶个/g、嗜酸细胞比例为(4.56±10.07)%、中性粒细胞比例为(50.32±26.12)%、淋巴细胞比例为(5.14±7.27)%、单核巨噬细胞比例为(40.30±16.70)%，EB患者组痰中细胞总计数为(5.46±3.07)×10⁶个/g、嗜酸细胞比例为(13.85±1 2.23)、中性粒细胞比例为(46.16±16.89)、淋巴细胞比例为(4.83±2.98)、单核巨噬细胞比例为(35.91±16.35)，两组间EB组嗜酸细胞比例有显著的增多(P<0.05)，在性别、年龄以及其余细胞成分差异无统计学意义(P>0.05)；EB患者组经治疗后，痰中细胞总计数为(4.07±3.89)×10⁶个/g、嗜酸细胞比例为(2.52±3.80)%、中性粒细胞比例为(54.18±17.97)%、淋巴细胞比例为(5.59±4.33)%、单核巨噬细胞比例为(38.32±17.23)%，嗜酸细胞较治疗前有显著减少(P<0.05)，其余细胞改变无显著差异(P>0.05)。

结论

诱导痰细胞分类检查是诊断EB的重要方法，在其诊断和治疗过程中有着重要的指导作用，可作为EB治疗过程的监测指标。

关键词: 诱导痰细胞分类, 嗜酸细胞性支气管炎, 诊断, 治疗

Objective

To explore the effect of induced sputum on the diagnosis and treatment of eosinophilic bronchitis (EB).

Methods

A total of 239 outpatients with chronic cough in our hospital were divided into an EB group and a non-EB group according to the diagnosis standard of EB. The cells in the induced sputum were analyzed for all the patients. Then the patients in the EB group were treated for 8 weeks, and the changes of the induced sputum were detected after treatment.

Results

Among the 239 patients with chronic cough, 216 (90.7%) were non-EB patients and 23 (9.3%) were EB patients. The percentage of eosinophils increased in the induced sputum of 121 (50.6%) patients in the two groups. The total cell count of non-EB patients was (4.83±2.61)×10⁶ cells/g, the proportion of eosinophils accounted for (4.56±10.07)%, and the proportion of neutrophils accounted for (50.32±26.12)%. The percentages of lymphocytes and monocyte-macrophages in the sputum accounted for (5.14±7.27)% and (40.30±16.70)%, respectively. In the induced sputum of the EB group, the total number of cells was (5.46±3.07)×10⁶ cells/g, the proportion of eosinophils accounted for (13.85±12.23)%, the proportion of neutrophils accounted for (46.16±16.89)%, the proportion of lymphocytes accounted for (4.83±2.98)%, and the monocyte-macrophages accounted for (35.91±16.35)%. The proportion of eosinophils was higher significantly in the EB group than the non-EB group (P<0.05). However, no significant difference was found in the sex, age or other cell components (P>0.05). After treatment in the EB group, the total number of cells was (4.70±3.89)×10⁶ cells/g, and the proportion of eosinophils accounted for (2.52±3.80)%, neutrophils for (54.18±17.97)%, lymphocytes for (5.59±4.33)%, and monocyte-macrophages for (38.32±17.23)% in the induced sputum. The proportion of eosinophils after treatment was significantly reduced compared with that before treatment (P<0.05). Similarly, there was no significant difference in other cell changes (P>0.05).

Conclusion

Analyzing the induced sputum was an important method for the diagnosis of EB, which plays an important role in the diagnosis and treatment of EB, and can also be used as a detection index in the treatment of EB.

Key words: Induced sputum, Eosinophilic bronchitis, Diagnosis, Treatment

表1 非EB组与EB患者诱导痰细胞分类比较

组　别		例数	总细胞计数(×10⁶个/g)	EOS(%)	NEU(%)	LYM(%)	MAC(%)
非EB组		236	4.83±2.61	4.56±10.07	50.32±26.12	5.14±7.27	40.30±16.70
EB组		23	5.46±3.07	13.85±12.23^a	46.16±16.89	4.83±2.98	35.91±16.35
	Z值		-1.133	-5.240	-1.239	-0.200	-1.121
	P值		0.257	<0.001	0.215	0.841	0.262

表1 非EB组与EB患者诱导痰细胞分类比较

组　别		例数	总细胞计数(×10⁶个/g)	EOS(%)	NEU(%)	LYM(%)	MAC(%)
非EB组		236	4.83±2.61	4.56±10.07	50.32±26.12	5.14±7.27	40.30±16.70
EB组		23	5.46±3.07	13.85±12.23^a	46.16±16.89	4.83±2.98	35.91±16.35
	Z值		-1.133	-5.240	-1.239	-0.200	-1.121
	P值		0.257	<0.001	0.215	0.841	0.262

图1 EB患者治疗前后诱导痰细胞变化；注：EOS：嗜酸细胞；NEU：中性粒细胞；MAC：单核巨噬细胞

表2 EB患者治疗前后诱导痰中细胞分类变化

组　别		总细胞计数(×10⁶个/g)	EOS(%)	NEU(%)	LYM(%)	MAC(%)
治疗前		5.46±3.07	13.85±12.23	46.16±16.89	4.83±2.98	35.91±16.35
治疗后		4.70±3.89	2.52±3.80^a	54.18±17.97	5.59±4.33	38.32±17.23
	Z/t值	3.954	20.149	-1.639	-0.669	-0.488
	P值	0.047	<0.001	0.115	0.511	0.631

表2 EB患者治疗前后诱导痰中细胞分类变化

组　别		总细胞计数(×10⁶个/g)	EOS(%)	NEU(%)	LYM(%)	MAC(%)
治疗前		5.46±3.07	13.85±12.23	46.16±16.89	4.83±2.98	35.91±16.35
治疗后		4.70±3.89	2.52±3.80^a	54.18±17.97	5.59±4.33	38.32±17.23
	Z/t值	3.954	20.149	-1.639	-0.669	-0.488
	P值	0.047	<0.001	0.115	0.511	0.631

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