Imhof-Burgener M, de Weck A, Bachofen H, Scherrer M
Schweiz Med Wochenschr. 1981 Feb 14;111(7):223-8.
From October 1977 to September 1979 69 out of 500 asthmatic patients were selected in whom case histories, skin tests and IgE blood-levels formed a sub-group with more or less pure allergic asthma and a sub-group with more or less pure intrinsic asthma. All the patients exhibited a large quantity of granulocytes in the bronchial and nasal secretions. Special attention was paid to the contents of eosinophils in the nasal smear and in the bronchial mucus. The intrinsic subgroup had a (non significantly) greater incidence of 100% eosinophils in the bronchial secretion than the allergic sub-group (p less than 0.1). Unexpectedly, the reverse was found in the nasal secretions: only 33% of the intrinsics (9 cases) and as many as 67% of the allergics (28 cases) exhibited 100% eosinophils in the nasal mucus (p less than 0.025). Thus, when discussing the two forms of asthma, allergic and intrinsic, it is always necessary to bear in mind the possible paradoxical behaviour between nasal and bronchial mucus: pure eosinophilia in the lower respiratory tract may often be found concomitantly with pure neutrophilia in the upper respiratory tract, when some of the criteria for intrinsic asthma are fulfilled.
1977年10月至1979年9月期间,从500名哮喘患者中选出69例,根据病史、皮肤试验和免疫球蛋白E(IgE)血浓度,将其分为或多或少属于纯过敏性哮喘的亚组和或多或少属于纯内源性哮喘的亚组。所有患者的支气管和鼻腔分泌物中均有大量粒细胞。特别关注鼻涂片和支气管黏液中的嗜酸性粒细胞含量。内源性哮喘亚组支气管分泌物中嗜酸性粒细胞占比100%的发生率(无显著差异)高于过敏性哮喘亚组(p<0.1)。出乎意料的是,鼻腔分泌物情况相反:内源性哮喘患者中只有33%(9例)的鼻腔黏液嗜酸性粒细胞占比100%,而过敏性哮喘患者中有多达67%(28例)的鼻腔黏液嗜酸性粒细胞占比100%(p<0.025)。因此,在讨论过敏性哮喘和内源性哮喘这两种哮喘形式时,必须始终牢记鼻腔和支气管黏液之间可能存在的矛盾现象:当满足某些内源性哮喘标准时,下呼吸道的纯嗜酸性粒细胞增多症可能常伴有上呼吸道的纯中性粒细胞增多症。