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目的探讨简便有效的诱导痰液及细胞分析方法,了解儿童哮喘发作期气道炎症的特点。方法运用高渗盐水雾化吸入诱导痰液的方法,收集37例哮喘发作期患儿、48例正常儿童(对照组)痰液。一部分痰液经二硫苏糖醇(DTT)液化后,在血球计数板上行细胞总计数;另一部分痰液涂片经瑞氏、甲苯胺蓝染色行细胞分类计数。结果哮喘组84%取痰成功,诱导过程中呼气峰流速(PEF)未见下降(P>005)。痰液细胞总计数哮喘组为(112±89)×109/L,对照组为(71±62)×109/L(P<005)。嗜酸性粒细胞、肥大细胞在哮喘发作期气道中明显升高(P<001)。结论诱导痰液分析、评判哮喘患儿气道炎症是一种安全、可靠的新研究方法;嗜酸性细胞、肥大细胞为哮喘发作的主要效应细胞。
Objective To investigate the simple and effective method of induced sputum and cell analysis to understand the characteristics of airway inflammation in childhood asthma attack. Methods The method of inducing sputum with inhalation of hypertonic saline was used to collect sputum from 37 children with asthma attack and 48 normal children (control group). A portion of sputum was dithiothreitol (DTT) liquefaction, the total count of cells in the blood count plate cells; the other part of the sputum smear by Wright, toluidine blue staining cells were counted. Results 84% sputum was successfully taken in the asthma group, and the peak expiratory flow rate (PEF) was not decreased during induction (P> 005). The total number of sputum cells in the asthma group was (112 ± 89) × 109 / L and in the control group (71 ± 62) × 109 / L (P <005). Eosinophils and mast cells were significantly increased during the asthma attack (P <001). Conclusion Induction of sputum analysis, evaluation of airway inflammation in children with asthma is a safe and reliable new research methods; eosinophils, mast cells are the main effector cells of asthma attacks.