急性哮喘气道炎症表型与激素治疗反应性的关系.doc

急性哮喘气道炎症表型与激素治疗反应性的关系 李志伟，马千里，张巧，曾兰，程晓明，林科雄，王长征 400037 重庆，第三军医大学新桥医院全军呼吸内科研究所 [摘要] 目的 研究急性哮喘气道炎症表型与激素治疗反应性的关系。 方法 采用回顾性的方法对85例急性哮喘患者的诱导痰炎症细胞进行分类，并研究了不同气道细胞炎症表型与患者使用全身激素剂量、天数等的关系。 结果 根据患者诱导痰炎症细胞分类的不同，将患者分为四组：嗜酸细胞组 31.8%，27/85 和中性粒细胞组 30.6%，26/85 、混合细胞组 16.4%，14/85 和寡细胞组 21.2%，18/85 。各组患者在性别和是否吸烟方面无统计学差异，但嗜酸细胞组患者严重程度与混合细胞组有统计学差异 P 0.05 。 嗜酸细胞组全身激素使用剂量及天数显著少于寡细胞和混合细胞组 P 0.05 。同期患者使用吸入激素剂量使用吸入激素天数方面，混合细胞组显著多于嗜酸细胞组 P 0.05 。中性粒细胞组吸入激素剂量显著少于混合细胞组 P 0.05 ，而嗜酸细胞组患者住院天数显著少于混合性细胞组 P 0.05 。其余各组间在全身激素使用剂量及天数、吸入激素使用剂量及天数、住院时间比较无统计学差异 P 0.05 。 结论 不同炎症表型对激素的治疗反应性可能存在差异。不同炎症表型对治疗的反应性差异可能给临床带来重要的指导意义。 [关键词] 诱导痰；哮喘急性加重；气道炎症；激素 Relationship between the phenotypes of airway inflammation and the responses to corticosteroid treatment in acute asthma Li Zhiwei, Ma Qianli, Zhang Qiao, Zeng Lan, Cheng Xiaoming, Lin Kexiong, Wang Changzheng* Institute of Respiratory Diseases, Xinqiao Hospital, Third Military Medical University. Chongqing, 400037, China. [Abstract] Objective To investigate the relationship between the phenotypes of airway inflammation and the responses to corticosteroid treatment in acute asthma. Methods　The inflammatory cells of the induced sputum obtained from 85 patients with acute asthma were classified, and the relationship between the phenotypes of airway inflammation and the dose of systemic corticosteroid and the treatment time of corticosteroid treatment was retrospectively analyzed in these patients. Results According to the classification of the sputum cells, the 85 acute asthmatic patients were divided into four groups including an eosinophil group 31.8%, 27/85 , a neutrophil group 30.6%, 26/85 , a mixed cell group 16.4%, 14/85 and a pauci-granulocyte group 21.2%, 18/85 . There was no significant difference of sex and smoking among the four groups P 0.05 , but the severity of acute asthma of the eosinophil group was significantly different from that of the mixed cell group P 0.05 . The total dose of systemic corticosteroid and the treatment ti