嗜酸性支气管炎而非哮喘患者发生不可逆性气流受限。
Development of irreversible airflow obstruction in a patient with eosinophilic bronchitis without asthma.
作者信息
Brightling C E, Woltmann G, Wardlaw A J, Pavord I D
机构信息
Dept of Respiratory Medicine, The Glenfield Hospital, Leicester, UK.
出版信息
Eur Respir J. 1999 Nov;14(5):1228-30. doi: 10.1183/09031936.99.14512289.
Eosinophilic bronchitis is a recently described condition presenting with chronic cough and sputum eosinophilia without the abnormalities of airway function seen in asthma. The patient, a 48-yr-old male who had never smoked, presented with an isolated chronic cough. He had normal spirometric values, peak flow variability and airway responsiveness, but an induced sputum eosinophil count of 33% (normal <1%). Although his cough improved with inhaled corticosteroids the sputum eosinophilia persisted. Over 2 yrs he developed airflow obstruction, which did not improve following nebulized bronchodilators and a 2-week course of prednisolone 30 mg once daily sufficient to return the sputum eosinophilia to normal (0.5%). It is suggested that the progressive irreversible airflow obstruction was due to persistent structural change to the airway secondary to eosinophilic airway inflammation, and it is further speculated that eosinophilic bronchitis may be a prelude to chronic obstructive pulmonary disease in some patients.
嗜酸性粒细胞性支气管炎是一种最近才被描述的疾病,表现为慢性咳嗽和痰液嗜酸性粒细胞增多,而无哮喘患者所见的气道功能异常。该患者为一名48岁从未吸烟的男性,以单纯慢性咳嗽就诊。他的肺功能测定值、呼气峰值流速变异性和气道反应性均正常,但诱导痰嗜酸性粒细胞计数为33%(正常<1%)。尽管吸入糖皮质激素后他的咳嗽有所改善,但痰液嗜酸性粒细胞增多持续存在。在2年多的时间里,他出现了气流受限,雾化支气管扩张剂以及每日一次服用30 mg泼尼松龙共2周的疗程(足以使痰液嗜酸性粒细胞增多恢复正常(0.5%))后,气流受限并未改善。提示进行性不可逆气流受限是由于嗜酸性粒细胞性气道炎症继发气道持续结构改变所致,并且进一步推测嗜酸性粒细胞性支气管炎在某些患者中可能是慢性阻塞性肺疾病的前奏。