Firestone Institute for Respiratory Health, St. Joseph's Healthcare & Department of Medicine, McMaster University, Hamilton, Ontario.
Can Respir J. 2011 May-Jun;18(3):144-8. doi: 10.1155/2011/430317.
Sputum cell counts have identified inflammatory subtypes of bronchitis in relatively small numbers of subjects with asthma, chronic obstructive pulmonary disease (COPD) and chronic cough in research studies. The prevalence of different subtypes of bronchitis in routine clinical practice, however, has not been reported.
To examine the heterogeneity of bronchitis and its relationship to the severity of airflow obstruction.
A retrospective cross-sectional survey based on a computerized database of spontaneous or induced sputum cell counts examined in a large university tertiary respiratory outpatient clinic.
The database contained 4232 consecutive sputum records from 2443 patients with chronic cough (39%), asthma (37%), asthma with COPD (9%), COPD (13%) and bronchiectasis (3%). Total and differential cell counts were obtained from 86% of successful sputum samples. Induced sputum provided more viable samples than spontaneous expectorate. Approximately one-third of patients with asthma and one-fifth of patients with COPD experience eosinophilic bronchitis. Asthmatic patients with moderate to severe airflow obstruction had a greater number of sputum eosinophils. There was a significantly higher number of total cell counts and percentage of neutrophils in the sputum of COPD patients with moderate and severe airflow obstruction than in those with mild airflow obstruction.
There is heterogeneity in the cellularity of sputum in various airway diseases. Patients with clinically stable airway diseases may have high sputum cell counts. During exacerbations, more patients may experience neutrophilic bronchitis. Severity of airflow obstruction is associated with eosinophilic bronchitis in patients with asthma, and neutrophilic bronchitis in patients with nonasthmatic COPD.
在哮喘、慢性阻塞性肺疾病（COPD）和慢性咳嗽的研究中，痰细胞计数已经确定了支气管炎症的亚型，但在常规临床实践中，不同类型的支气管炎的患病率尚未报道。
检查支气管炎的异质性及其与气流阻塞严重程度的关系。
一项基于大型大学三级呼吸门诊中计算机化的自发性或诱导性痰细胞计数数据库的回顾性横断面调查。
该数据库包含了 2443 名慢性咳嗽（39%）、哮喘（37%）、哮喘合并 COPD（9%）、COPD（13%）和支气管扩张症（3%）患者的 4232 份连续痰记录。86%的成功痰液样本中获得了总细胞计数和分类细胞计数。诱导痰比自发性咳痰提供了更多的可培养样本。大约三分之一的哮喘患者和五分之一的 COPD 患者经历嗜酸性粒细胞性支气管炎。中重度气流阻塞的哮喘患者痰中嗜酸性粒细胞数量较多。中重度气流阻塞的 COPD 患者的痰总细胞计数和中性粒细胞百分比明显高于轻度气流阻塞的患者。
各种气道疾病的痰细胞成分存在异质性。患有临床稳定气道疾病的患者可能有高痰细胞计数。在恶化期间，更多的患者可能会经历中性粒细胞性支气管炎。哮喘患者的气流阻塞严重程度与嗜酸性粒细胞性支气管炎有关，非哮喘性 COPD 患者与中性粒细胞性支气管炎有关。
