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目的:观察嗜酸粒细胞性支气管炎(EB)气道粘膜炎症的病理特征,并与咳嗽变异型哮喘(CVA)进行比较。方法:对11例EB患者行纤支镜支气管粘膜活检,并以10例正常对照、10例CVA和14例典型支气管哮喘的支气管粘膜标本作对照。光镜下测量各组气道粘膜上皮的基底膜厚度,并通过免疫组化和特殊染色技术,计算EB和CVA组气道粘膜固有层中炎症细胞(嗜酸粒细胞、肥大细胞、T淋巴细胞)的浸润密度。结果:EB组支气管粘膜基底膜厚度[2.92μm(2.10-6.50)μm]显著高于对照组[2.08μm(1.62-3.40μm)],P<0.05,同时显著低于CVA组[5.64μm(3.23-8.48μm)],P<0.05,而CVA组的基底膜厚度又显著低于典型哮喘组[9.08μm(6.61-11.99μm)],P<0.01;EB组气道粘膜固有层可见肥大细胞和嗜酸粒细胞散在分布,浸润密度分别为[75 cells/mm2(35-112cells/mm2)]和[7 cells/mm2(0-31 cells/mm2)],显著低于CVA组[148 cells/mm2(34-200 cells/mm2),114 cells/mm2(1-768 cells/mm2)],P<0.05,淋巴细胞浸润密度无显著差异。结论:EB是以嗜酸细胞浸润为特征,涉及多种炎症细胞的慢性气道炎症性疾病,但气道粘膜基底膜厚度显著低于CVA和典型哮喘,炎症细胞浸润程度低于CVA,均可能是EB缺乏气道高反应性的重要机制。
Objective: To observe the pathological features of airway mucosal inflammation in eosinophilic bronchitis (EB) and to compare with cough variant asthma (CVA). Methods: Bronchial mucosa biopsy was performed on 11 EB patients. Bronchial mucosa specimens of 10 normal controls, 10 CVA and 14 patients with typical bronchial asthma were used as controls. The basement membrane thickness of airway mucosal epithelium of each group was measured by light microscope, and the inflammatory cells (eosinophils, mast cells and T lymphocytes) in lamina propria of EB and CVA group were calculated by immunohistochemistry and special staining techniques ) Infiltration density. Results: The thickness of bronchial mucosa in EB group [2.92μm (2.10-6.50) μm] was significantly higher than that in control group [2.08μm (1.62-3.40μm]], P <0.05, and significantly lower than that in CVA group [5.64μm -8.48μm)], P <0.05, while the CVA group was significantly lower than the basement membrane thickness of the asthma group [9.08μm (6.61-11.99μm)], P <0.01 EB group visible mast cells and airway mucosa Eosinophils scattered distribution, infiltration density were 75 cells / mm2 (35-112 cells / mm2)] and [7 cells / mm2 (0-31 cells / mm2)], significantly lower than CVA group [148 cells / mm2 (34-200 cells / mm2), 114 cells / mm2 (1-768 cells / mm2)], P <0.05. There was no significant difference in lymphocyte infiltration density. CONCLUSION: EB is a chronic airway inflammatory disease characterized by eosinophilic infiltration involving a variety of inflammatory cells. However, the basement membrane thickness of airway mucosa is significantly lower than that of CVA and typical asthma, and infiltration of inflammatory cells is lower than that of CVA EB is an important mechanism of lack of airway hyperresponsiveness.