The Study Of Inflammatory Cells Typing In Induced Sputum In Patients With Refractory Asthma

Objective:To explore the phenotype of airway inflammation and clinical features in refractory asthma and provide a new approach of diagnosis and treatment,all refractory asthma patients were examined by induced sputum cytology,and inflammatory cells were typed. Methods:97 patients with diagnosis of refractory asthma were enrolled in Xinjiang Uygur region people hospital from January,2012 to June,2014,all cases were grouped according to the induced sputum cytology.We collected patients’clinical data such as history blood test, induced sputum cytology and pulmonary function test.All results were analyzed with SPSS 20 statistical software.Measurement data were measured by using non-parametric test,median(P25,P75);enumeration data were measured by rate..It indicated statistical significance when P<0.05. Results:1.59cases with eosinophilic asthma,24 subjects with neutrophilic asthma and 14 cases with mixed granulocytic asthma were found in refractory asthma(RA) patients according to the types of inflammtory cells in induced sputum test.2. Ages, VCMAX, FEV], FEF75 showed statistical significance(χ2=8.272, P=0.01; χ2=7.473,P=0.024;χ2=6.298,P=0.043;χ2=7.487,P=0.024).3. Ages, VCMAX, FEV1, FEF75 were significant between neutrophilic asthma group and eosinophil asthma group(Z=-2.268,P=0.023; Z=-2.468,P=0.014; Z=-2.205,P=0.027; Z=-2.048,P=0.041). 4.VCMAX, FEV1, FEF75 revealed significance between neutrophilic asthma group and mixed granulocytic asthma group(Z=-2.180,P=0.029; Z=-1.999,P=0.047; Z=-2.818, P=0.004).5.Ages showed significance between eosinophil asthma group and mixed granulocytic group(Z=-2.182,P=0.029). Conclusions:1.Female patients were more common in refractory asthma,which associated with exposure to the high-risk population, usually accompanied by rhinitis, nasal polyp,gastroesophageal reflux.anxiety and depression.2.Most patients had poor pulmonary function, the airflow limitation and incompletely reversibility.3.Eosinophil asthma was the most common phenotype among respiratory tract inflammation phenotypes,had higher proportion than other groups.patients were the oldest in eosinophil asthma,patients were the earliest in mixed granulocytic asthma,pulmoanry function showed better in neutrophilic asthma group compared to another two groups.