Moritz Pablo, Steidle Leila John Marques, Felisbino Manuela Brisot, Kleveston Túlia, Pizzichini Marcia Margaret Menezes, Pizzichini Emilio
Universidade Federal de Santa Catarina, Florianópolis, SC, Brasil.
J Bras Pneumol. 2008 Nov;34(11):913-21. doi: 10.1590/s1806-37132008001100005.
To evaluate the usefulness of determining the inflammatory component of airway diseases (inflammometry) by induced sputum cell counts, as well as its influence on treatment decisions in a tertiary facility for the treatment of respiratory diseases.
We analyzed 151 sputum samples from 132 consecutive patients referred for clinical sputum induction by five pulmonologists between July of 2006 and February of 2007. A structured questionnaire related to the reasons for requesting the test and to the therapeutic decision making based on test results was completed by each attending physician upon receiving the test results. Induced sputum was obtained and processed according to a technique previously described.
The principal motives for ordering the test were inhaled corticosteroid dose titration in patients with moderate-to-severe asthma (in 54.3%), investigation of chronic cough (in 30.5%), and monitoring airway inflammation in patients with bronchiectasis (in 7.3%) or chronic obstructive pulmonary disease (in 6%). Of the 82 patients with asthma, 47 (57%) presented eosinophilic bronchitis (>3% eosinophils). Nonasthmatic eosinophilic bronchitis was diagnosed in 9 (19%) of the 46 patients with chronic cough. Neutrophilic bronchitis (>65% neutrophils) was found in 13 patients, of which 5 had asthma, 2 had chronic cough, and 6 had chronic obstructive pulmonary disease/bronchiectasis. Based on the induced sputum results, the corticosteroid dose was modified in 48 asthma patients (64.7%).
The systematic application of inflammometry using induced sputum cell counts can be beneficial for patients with airway diseases, particularly those with asthma or chronic cough.
通过诱导痰细胞计数评估气道疾病炎症成分测定（炎症测定法）的实用性，以及其对三级呼吸疾病治疗机构治疗决策的影响。
我们分析了2006年7月至2007年2月期间由五位肺科医生连续转诊进行临床痰诱导的132例患者的151份痰样本。每位主治医生在收到检测结果后，完成一份与检测申请原因以及基于检测结果的治疗决策相关的结构化问卷。诱导痰按照先前描述的技术获取并处理。
进行该检测的主要动机是中重度哮喘患者吸入性糖皮质激素剂量滴定（54.3%）、慢性咳嗽的调查（30.5%）以及支气管扩张症（7.3%）或慢性阻塞性肺疾病（6%）患者气道炎症的监测。在82例哮喘患者中，47例（57%）表现为嗜酸性粒细胞性支气管炎（嗜酸性粒细胞>3%）。46例慢性咳嗽患者中有9例（19%）被诊断为非哮喘性嗜酸性粒细胞性支气管炎。13例患者发现中性粒细胞性支气管炎（中性粒细胞>65%），其中5例有哮喘，2例有慢性咳嗽，6例有慢性阻塞性肺疾病/支气管扩张症。基于诱导痰结果，48例哮喘患者（64.7%）的糖皮质激素剂量得到调整。
使用诱导痰细胞计数进行炎症测定法的系统应用对气道疾病患者有益，尤其是哮喘或慢性咳嗽患者。
