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目的比较中性粒细胞性哮喘(NA)与慢性阻塞性肺疾病(COPD)稳定期患者诱导痰中性粒细胞的炎症程度。方法收集2014年3月至2014年8月到我院呼吸科门诊及研究所就诊的25例NA患者、30例COPD稳定期患者及11例健康正常人的病例资料。进行诱导痰白细胞分类计数,ELISA检测诱导痰上清中髓过氧化物酶(MPO)、基质金属蛋白酶抑制剂-1(TIMP-1)、IL-8、IL-17的水平,流式细胞术检测诱导痰中性粒细胞的呼吸爆发。结果 NA组与稳定期COPD组患者诱导痰细胞总数和中性粒细胞百分比均显著高于健康对照组(P<0.05),2组间无统计学差异(P>0.05);NA组和稳定期COPD组患者诱导痰上清MPO、TIMP-1、IL-8、IL-17水平均显著高于健康对照组(P<0.05),稳定期COPD组IL-8、IL-17水平显著高于NA组(P<0.05);NA组与稳定期COPD组患者间MPO、TIMP-1及呼吸爆发无统计学差异(P>0.05);NA组和稳定期COPD组患者肺功能FEV1(%)和FEV1/FVC(%)之间呈正相关(r=0.66和0.75,P<0.05),其余2组内FEV1(%)、FEV1/FVC(%)、MPO、TIMP-1、IL-8、IL-17及呼吸爆发这些指标间均无显著相关性(P>0.05)。结论 NA组和稳定期COPD组患者诱导痰中性粒细胞明显活化,2组间的差异有待更多实验观察。
Objective To compare the degree of inflammation induced by sputum neutrophils in patients with stable neutrophilic asthma (NA) and chronic obstructive pulmonary disease (COPD). Methods The data of 25 NA patients, 30 stable COPD patients and 11 healthy controls were collected from our Department of Respiratory Clinic and Institute from March 2014 to August 2014. The levels of MPO, TIMP-1, IL-8 and IL-17 in induced sputum supernatant were detected by ELISA. The levels of IL-8 and IL-17 were detected by flow cytometry Detection of induced sputum neutrophils respiratory burst. Results The total number of induced sputum cells and neutrophils in NA group and stable COPD group were significantly higher than those in healthy control group (P <0.05), but there was no significant difference between the two groups (P> 0.05) The levels of MPO, TIMP-1, IL-8 and IL-17 in induced sputum in patients with COPD were significantly higher than those in healthy controls (P <0.05). The levels of IL-8 and IL-17 in COPD patients were significantly higher than those in NA patients (P <0.05). There was no significant difference in MPO, TIMP-1 and respiratory burst between NA group and stable COPD patients (P> 0.05). FEV1 (%) and FEV1 / FVC (%) (r = 0.66 and 0.75, P <0.05). In the other two groups, FEV1, FEV1 / FVC, MPO, TIMP- 1, IL-8 and IL- 17 And respiratory burst no significant correlation between these indicators (P> 0.05). CONCLUSION: The sputum neutrophils are activated obviously in patients with NA and stable COPD. The difference between the two groups needs more experimental observation.