哮喘联盟

   摘要
   背景：早期识别哮喘急性发作的严重程度将有助于对患者的处理。本研究旨在评估嗜酸性粒细胞形态学改变和哮喘发作严重程度的关联。
   方法：血液样本收集自55例哮喘患儿（40例处于急性发作期，15例无症状）和15例健康对照。涂片后，计数发生形态学改变的嗜酸性粒细胞百分比（单个或多个伪足形成，出现胞浆空泡，释放小量、中量或大量颗粒，伸展，嗜酸性粒细胞死亡和单个嗜酸性粒细胞簇的形成），并使用秩和检验进行比较。同时，使用Spearman's相关分析法检测哮喘发作严重性和嗜酸性粒细胞形态学改变发生率的相关性。
   结果：与对照组相比，无症状患儿活化嗜酸性粒细胞的比例更高，哮喘急性发作组嗜酸性粒细胞活化率进一步增高（P<0.01)。出现较多的形态学改变是多个伪足的形成、胞浆空泡的出现、播散和嗜酸性粒细胞簇的形成(P < 0.001)。以下几项与哮喘发作的严重程度相关：≥14%嗜酸性粒细胞出现单一伪足，8%出现多个伪足，17%有胞浆空泡，28%嗜酸性粒细胞释放大量的颗粒，以及66%嗜酸性粒细胞出现播散。
   结论：通过定量嗜酸性粒细胞的形态学改变来辨别哮喘急性发作的严重程度是一种可行的、简单的、可靠的评估方法，因而可改善对哮喘患儿的临床处理。
 

（刘国梁 审校）
Allergy. 2013 Jun 7. doi: 10.1111/all.12176. [Epub ahead of print]

 

Morphological changes in eosinophils are reliable markers of the severity of an acute asthma exacerbation in children.
 

Muniz-Junqueira MI, Barbosa-Marques SM, Junqueira LF Jr.
 

Abstract
BACKGROUND: Early identification of the severity of asthma exacerbation would be helpful for the management of patients. We aimed to evaluate the correlation of morphological change in activated eosinophils and the severity of an asthma exacerbation.
METHODS: Blood was collected from 55 asthmatic children: 40 of whom were having an exacerbation, 15 symptom-free, and 15 healthy controls. The percentage of eosinophils with morphological changes (emission of single or multiple pseudopods, presence of cytoplasmic vacuoles, releasing a small, moderate, or large quantity of granules, spreading, eosinophil death, and presence of cluster of free eosinophil granules) was quantified after the adherence to a slide and compared using the Mann-Whitney test. The correlation between the severity of the asthma exacerbation and the percentage changed eosinophils was tested with Spearman's correlation.
RESULTS: The proportion of activated eosinophils was higher in asthmatic symptom-free children than in the control group, and acute asthma exacerbation produced an additional increase in eosinophil activation (P < 0.01). More significantly increased morphological changes were emissions of multiple pseudopods, presence of cytoplasmic vacuoles, spreading, and presence of a cluster of free eosinophil granules (P < 0.001). The following were correlated with the severity of an asthma exacerbation: ≥14% of eosinophils emitting single pseudopod, 8% emitting multiple pseudopods, 17% with vacuoles, 28% eosinophils releasing a large quantity of granules, and 66% of spread eosinophils.
CONCLUSIONS: Quantifying the morphological changes in eosinophils is a feasible, easy, and reliable manner to identify the severity of an asthma exacerbation and therefore might improve the clinical management of asthmatic children.
 

Allergy. 2013 Jun 7. doi: 10.1111/all.12176. [Epub ahead of print]