| 引用本文： |
-
王宇,余莉,吕寒静,等.胃食管反流性咳嗽患者诱导痰中肥大细胞相关介质的改变及其意义[J].同济大学学报（医学版）,2010,31(4):55-61. [点击复制]
- WANG Yu,YU Li,L Han-jing,et al.Evaluation of functional changes of mast cell associated mediators in the induced sputum from patients with gastroesophageal reflux-related chronic cough[J].同济大学学报（医学版）,2010,31(4):55-61. [点击复制]
|
|
| 摘要: |
| 目的探讨气道肥大细胞在胃食管反流性咳嗽（gastroesophageal reflux—related chronic cough，GERC）发生中的作用。方法选择GERC患者10例，对照组分别为无咳嗽胃食管反流病（gastroesophageal reflux disease，GERD）患者10例和正常健康志愿者10名。三组均接受咳嗽敏感性试验、肺功能和诱导痰细胞分析检查。比较三组间咳嗽敏感性、肺功能指标、诱导痰中炎症细胞总数和分类计数以及诱导痰上清液中肥大细胞类胰蛋白酶（mast cell tryptase，MCT）、组胺、前列腺素D2（prostaglandin D2，PGD2）、前列腺素E2（prostaglandin E2，PGE2）、嗜酸性粒细胞阳离子蛋白（eosinophil cationic protein，ECP）、白细胞介素-8（interleukin-8，IL-8）及P物质（substance P，SP）含量的差异。结果GERC组较无咳嗽GERD组反流症状轻，反流症状积分明显低于GERD组（P〈0．05）。GERC组咳嗽评分日间明显高于夜间（P〈0．05），咳嗽阈值C2、C5明显低于无咳嗽GERD组和正常对照组（P〈0．05）。但肺通气功能指标如FEV，％、FVC％、FEV1／FVC和PEF％的差别均无统计学意义。GERC组诱导痰中细胞总数及细胞分类计数虽与无咳嗽GERD组和正常对照组相似，但诱导痰中MCT、SP和PGE2水平明显高于无咳嗽GERD组（P〈0．05），而组胺、PGD2、ECP和IL-8三组间无明显差异。诱导痰中MCT和SP与辣椒素咳嗽阈值LogC5间存在显著负相关（MCT：r=-0．571，P〈0．01；SP：r=-0．569，P〈0．01）。结论GERC患者较GERD患者有更高的咳嗽敏感性，除气道神经肽外，肥大细胞在下气道的激活可能是GERC咳嗽的机制之一。 |
| 关键词: 胃食管反流性咳嗽 辣椒素 咳嗽敏感性 肥大细胞 P物质 类胰蛋白酶 前列腺素E2 |
| DOI： |
|
| 基金项目:上海市科委科技发展基金资助项目（074119628) |
|
| Evaluation of functional changes of mast cell associated mediators in the induced sputum from patients with gastroesophageal reflux-related chronic cough |
| WANG Yu,YU Li,L Han-jing,QIU Zhong-min |
| () |
| Abstract: |
| Objectives To explore the effects of mast cells in airway on the pathogenesis of GERC. Methods Ten patients with GERC, ten patients with GERD without cough and ten healthy volunteers were selected in the study. Cough reflex sensitivity test was carried out with capsaicin stimulation. The examination of lung functions and the cytology of induced sputum were performed. The cough thresholds to capsaicin, lung function parameters, total cell numbers and its category in induced sputum were analyzed. Moreover, levels of mast cell tryptase, histamine, prostaglandin D2, prostaglandin E2, eosinophil cationic protein, interleukin-8 and substance P were measued in the supernatants of induced sputum by ELISA. Results Patients with GERC had significant lower frequency of reflux- related symptoms when compared with patients with GERD without cough as indicated by RDQ （ P 〈 0. 001 ）. Patients with GERC had more severe cough during day time than that at night time （P 〈 0.05）. Cough thresholds C2 and C5 were significantly lower in GERC group than that in GERD without cough group （P 〈 0.05 ）. Lung function parameters such as FEV1, FVC, FEV1/FVC and PEF had no significant differences among three groups. Although there were no significant differences observed in number of total cell and percentage of different category of inflammatory cells in the sputum, the levels of mast cell tryptase, prostaglandin E2 and substance P were elevated in the supernatant of induced sputum from GERC group when compared with GERD without cough group （P 〈 0. 05 ）. Concentrations of histamine, prostaglandin D2, eosinophil cationic protein and interleukin-8 were remained similar. More interestingly, there was an apparent negative correlation between Log C5 and mast cell tryptas （ r = - 0. 571, P 〈 0.01 ） or substance P （ r = - 0. 569, P 〈 0.01 ）. Conclusion GERC has an increased level of cough reflex sensitivity when compared with GERD without cough. Besides tachykinin in the airway, the activation of mast cell in the lower airway may involve in the pathogenesis of GERC. |
| Key words: gastroesophageal reflux-related chronic cough capsaicin cough reflex sensitivity mast cell tryptase substance P prostaglandin E2 |
