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目的:探讨支气管舒张试验阳性的稳定期慢性阻塞性肺疾病(COPD)气道炎症特征。方法:对63例稳定期COPD患者作肺功能测定和支气管舒张试验,并分别采用瑞氏染色、荧光免疫法和酶联免疫吸附试验检测诱导痰中细胞学计数、嗜酸性粒细胞阳离子蛋白(ECP)和髓过氧化物酶(MPO)、白介素-5(IL-5)、白介素-8(IL-8)水平。选择30名急性发作期哮喘患者和20名健康人作为对照。结果:63例稳定期COPD患者中,支气管舒张试验阳性15例(23.8%)。支气管舒张试验阳性的COPD患者诱导痰中嗜酸性粒细胞(EOS)[(4.9±2.1)%]和ECP[(121.3±60.2)μg/L]水平显著高于支气管舒张试验阴性的COPD患者(P<0.05)和健康对照组(P<0.01),但显著低于哮喘组(P<0.01);患者诱导痰IL-5水平[(14.6±8.1)μg/L]显著低于哮喘患者(P<0.01),与支气管舒张试验阴性的COPD患者和健康对照组比较差异无统计学意义(P>0.05);患者诱导痰中性粒细胞数量[(58.1±14.3)%]、MPO[(521.9±98.5)μg/L]和IL-8[(30.2±12.7)μg/L]水平与支气管舒张试验阴性的COPD患者比较差异无统计学意义(P>0.05),但显著高于哮喘组和健康对照组(P<0.01)。结论:支气管舒张试验阳性的COPD患者既具有气道嗜酸性粒细胞炎症特征,又存在气道中性粒细胞炎症。
Objective: To investigate the bronchial diastolic test positive chronic obstructive pulmonary disease (COPD) airway inflammation. Methods: Sixty-three patients with stable COPD underwent lung function test and bronchodilatation test. Wright’s staining, immunofluorescence and enzyme-linked immunosorbent assay were used to detect cytological count, eosinophil cationic protein (ECP) ) And myeloperoxidase (MPO), interleukin-5 (IL-5) and interleukin-8 (IL-8) Thirty acute exacerbation asthma patients and 20 healthy individuals were selected as control. Results: Among 63 stable COPD patients, bronchial dilation test was positive in 15 cases (23.8%). The levels of induced sputum eosinophils (EOS) [(4.9 ± 2.1)%] and ECP [(121.3 ± 60.2) μg / L] in COPD patients with bronchodilator test were significantly higher than those in COPD patients with bronchodilator test negative (P <0.01), but significantly lower than those in asthma group (P <0.01). IL-5 level in induced sputum was significantly lower than that in asthmatic patients (P <0.01) 0.01). There was no significant difference between COPD patients with bronchial dilatation test and healthy controls (P> 0.05). The number of induced sputum neutrophils [(58.1 ± 14.3)%], MPO [(521.9 ± 98.5) ) μg / L] and IL-8 [(30.2 ± 12.7) μg / L] were not significantly different from COPD patients with bronchodilator test negative (P> 0.05), but significantly higher than those of asthma group and healthy control group (P <0.01). CONCLUSIONS: COPD patients with positive bronchodilator tests have both airway eosinophilic inflammation and airway neutrophilic inflammation.