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目的探讨婴幼儿喘息时鼻咽分泌物涂片中嗜酸粒细胞计数及与血清特异性IgE的关系。方法选择2002-2004年收治的1个月～3岁的喘息及支气管肺炎患儿223例,分为3组,其中反复喘息(包括婴幼儿哮喘和喘息发作≥2次)组76例,毛细支气管炎组65例,支气管肺炎(无喘息症状)组82例。吸取鼻咽分泌物1ml进行嗜酸粒细胞计数,并测定血清特异性IgE的水平。结果反复喘息组鼻咽分泌物嗜酸粒细胞计数明显高于其他两组,差异有统计学意义(P=0.000);反复喘息组血清食物变应原(fx5E)的阳性检出率及吸入性变应原(Phadiatop)阳性检出率均明显高于其他两组,差异有统计学意义(P=0.000),毛支组和支气管肺炎组之间差异则无统计学意义;血清特异性IgE与鼻咽分泌物嗜酸粒细胞计数之间存在显著正相关;鼻咽分泌物嗜酸粒细胞水平在同时存在喘息和特应性的患儿最高,在既没有喘息也无个人特应性的患儿最低,有喘息或血清IgE一项者介于两组之间。结论鼻咽分泌物嗜酸粒细胞计数方法操作简单、无创、快速,费用低,且能在一定程度上反映哮喘的病理特征,与血清特异性IgE之间呈正相关,可以在临床进一步推广应用。
Objective To investigate the eosinophil count in nasopharyngeal secretion smear and the relationship with serum specific IgE in infant wheezing. Methods A total of 223 children with wheeze and bronchopneumonia aged from 1 month to 3 years who were admitted from 2002 to 2004 were divided into 3 groups. Among them, 76 were repeated wheezing (including infants with wheezing and wheezing ≥ 2), bronchioles 65 cases of inflammation, bronchial pneumonia (no wheezing symptoms) group of 82 cases. 1 ml of nasopharyngeal secretions was taken for eosinophil count, and the level of serum-specific IgE was measured. Results The eosinophil count of nasopharyngeal secretions in patients with recurrent wheeze was significantly higher than those in the other two groups (P = 0.000). The positive rate of detectable food allergens (fx5E) and inhalation Phadiatop positive rate was significantly higher than the other two groups, the difference was statistically significant (P = 0.000), between the branch of bronchitis and bronchial pneumonia, the difference was not statistically significant; serum specific IgE and Nasopharyngeal secretions eosinophil count there is a significant positive correlation; nasopharyngeal secretions eosinophil levels in children with both wheezing and atopy of the highest in both no wheezing and no personal atopic Children with the lowest, wheezing or serum IgE were between the two groups. Conclusion The eosinophil count method of nasopharyngeal secretions is simple, noninvasive, rapid, low cost, and can reflect the pathological features of asthma to a certain extent. It has a positive correlation with serum specific IgE and can be further popularized and applied in clinic.