全部 标题 作者
关键词 摘要

OALib Journal期刊
ISSN: 2333-9721
费用:99美元

查看量下载量

相关文章

更多...
-  2016 

慢性阻塞性肺疾病诱导痰细胞分类特点及其与治疗反应性的相关性分析

DOI: doi:10.7507/1671-6205.2016124

Keywords: 慢性阻塞性肺疾病, 诱导痰, 嗜酸粒细胞, 治疗反应性

Full-Text   Cite this paper   Add to My Lib

Abstract:

目的探讨慢性阻塞性肺疾病(简称慢阻肺)诱导痰细胞分类特点及其与治疗反应性的相关性。 方法检测65例初诊慢阻肺患者诱导痰细胞分类特点, 分析其与肺功能、功能性呼吸困难评分、圣乔治呼吸问卷评分(SGRQ)的相关性, 并分析嗜酸粒细胞(Eos)百分比与慢阻肺治疗反应性的相关性。 结果慢阻肺稳定期患者诱导痰中性粒细胞(Neu)、巨噬细胞、Eos、淋巴细胞百分比分别为(86.24±15.04)%、(5.75±6.96)%、(4.71±4.79)%、(1.30±1.09)%, 其中Eos百分比≥3%者31例(60.78%)。Neu百分比与FEV 1、FEV 1% pred、FVC、FVC% pred呈负相关( P均<0.01), 与SGRQ症状评分呈正相关( r=0.304, P=0.034)。Eos百分比与FEV 1/FVC呈负相关( r=-0.399, P=0.004)。给予丙酸氟替卡松+沙美特罗治疗后, Eos百分比≥3%者肺功能及症状改善较Eos百分比<3%者更加显著( P均<0.05)。 结论部分稳定期慢阻肺可表现为嗜酸粒细胞性炎症, 诱导痰Eos百分比与慢阻肺气流受限呈负相关, 对长效型糖皮质激素联合β 2受体激动剂治疗反应较好

References

[1]  1. Negewo NA, McDonald VM, Baines KJ, et al. Peripheral blood eosinophils:a surrogate marker for airway eosinophilia in stable COPD. Int J Chron Obstruct Pulmon Dis, 2016, 11:1495-1504.
[2]  2. Zanini A, Cherubino F, Zampogna E, et al. Bronchial hyperresponsiveness, airway inflammation, and reversibility in patients with chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis, 2015, 10:1155-1161.
[3]  3. Brightling CE, Monteiro W, Ward R, et al. Sputum eosinophilia and short-term response to prednisolone in chronic obstructive pulmonary disease:a randomised controlled trial. Lancet, 2000, 356:1480-1485.
[4]  4. Brightling CE, Bleecker ER, Panettieri RA Jr, et al. Benralizumab for chronic obstructive pulmonary disease and sputum eosinophilia:a randomised, double-blind, placebo-controlled, phase 2a study. Lancet Respir Med, 2014, 2:891-901.
[5]  6. Kang HS, Rhee CK, Kim SK, et al. Comparison of the clinical characteristics and treatment outcomes of patients requiring hospital admission to treat eosinophilic and neutrophilic exacerbations of COPD. Int J Chron Obstruct Pulmon Dis, 2016, 11:2467-2473.
[6]  8. Eltboli O, Bafadhel M, Hollins F, et al. COPD exacerbation severity and frequency is associated with impaired macrophage efferocytosis of eosinophils. BMC Pulmon Med, 2014, 14:112-121.
[7]  14. 张伟兵, 王欣燕, 田晓彦, 等.ADAM33基因多态性影响慢性阻塞性肺疾病气道炎症.中国呼吸与危重监护杂志, 2012, 11:15-18.
[8]  15. 郑劲平.关于制定我国用力肺功能检测质量控制指引的建议.中华结核和呼吸杂志, 2004, 27:716-717.
[9]  16. Celli BR, MacNee W, ATS/ERS Task Force. Standards for the diagnosis and treatment of patients with COPD:a summary of the ATS/ERS position paper. Eur Respir J, 2004, 23:932-946.
[10]  17. Djukanovi Ac'G R, Sterk PJ, Fahy JV, et al. Standardised methodology of sputum inductionf and processing. Eur Respir J Suppl, 2002, 37:1s-2s.
[11]  20. Davidson WJ, Verity WS, Traves SL, et al. Effect of incremental exercise on airway and systemic inflammation in patients with COPD. J Appl Physiol, 2012, 112:2049-2056.
[12]  23. Bafadhel M, McKenna S, Terry S, et al. Acute exacerbations of chronic obstructive pulmonary disease identification of biologic clusters and their biomarkers. Am J Respir Crit Care Med, 2011, 184:662-671.
[13]  21. Liesker JJ, Bathoorn E, Postma DS, et al. Sputum inflammation predicts exacerbations after cessation of inhaled corticosteroids in COPD. Respir Med, 2011, 105:1853-1860.
[14]  5. Barnes NC, Sharma R, Lettis S, et al. Blood eosinophils as a marker of response to inhaled corticosteroids in COPD. Eur Respir J, 2016, 47:1374-1382.
[15]  7. Bafadhel M, Greening NJ, Harvey-Dunstan TC, et al. Blood eosinophils and outcomes in severe hospitalized exacerbations of COPD. Chest, 2016, 150:320-328.
[16]  9. Duman D, Aksoy E, Agca MC, et al. The utility of inflammatory markers to predict readmissions and mortality in COPD cases with or without eosinophilia. Int J Chron Obstruct Pulmon Dis, 2015, 10:2469-2478.
[17]  10. Hospers JJ, Schouten JP, Weiss ST, et al. Eosinophilia is associated with increased all-cause mortality after a follow-up of 30 years in a general population sample. Epidemiology, 2000, 11:261-268.
[18]  11. Siva R, Green RH, Brightling CE, et al. Eosinophilic airway inflammation and exacerbations of COPD:a randomized controlled trial. Eur Respir J, 2007, 29:906-913.
[19]  12. Soter S, Barta I, Antus B. Predicting sputum eosinophilia in exacerbations of COPD using exhaled nitric oxide. Inflammation, 2013, 36:1178-1185.
[20]  13. 中华医学会呼吸病学分会慢性阻塞性肺疾病学组.慢性阻塞性肺疾病诊治指南(2013年修订版).中华结核和呼吸杂志, 2013, 36:255-264.
[21]  18. Perng DW, Huang HY, Chen HM, et al. Characteristics of airway inflammation and bronchodilator reversibility in COPD:a potential guide to treatment. Chest, 2004, 126:375-381.
[22]  19. 罗炜, 赖克方, 钟南山.诱导痰检测的方法学及其在气道炎症评价中的应用.国外医学呼吸系统分册, 2004, 24:395-397.
[23]  22. Bafadhel M, McKenna S, Terry S, et al. Blood eosinophils to direct corticosteroid treatment of exacerbations of chronic obstructive pulmonary disease:a randomized placebo-controlled trial. Am J Respir Crit Care Med, 2012, 186:48-55.
[24]  24. Brightling CE, McKenna S, Hargadon B, et al. Sputum eosinophilia and the short term response to inhaled mometasone in chronic obstructive pulmonary disease. Thorax, 2005, 60:193-198.
[25]  25. Ernst P, Saad N, Suissa S. Inhaled corticosteroids in COPD:the clinical evidence. Eur Respir J, 2015, 45:525-37.
[26]  26. Vestbo J, Pauwels R, Anderson JA, et al. Early onset of effect of salmeterol and fluticasone propionate in chronic obstructive pulmonary disease. Thorax, 2005, 60:301-314.

Full-Text

Contact Us

service@oalib.com

QQ:3279437679

WhatsApp +8615387084133