Montesanti M, Testa G, Biagi C, Bartolini F
Regione Toscana, Azienda USL 2, Lucca.
Minerva Pediatr. 1997 May;49(5):179-86.
Acute bacterial and viral infections are accompanied by a marked diminution in circulating eosinophils in the blood. This forms part of the host's physiological response to acute infection and was first studied in adults early this century. The aims of this study were to check whether eosinopenia during acute phlogosis is a phenomenon present in pediatric patients, and whether the trend is comparable to the experimental models reported; to describe the trend of circulating eosinophils in the remission process.
A retrospective study was performed in 34 children hospitalised in the Pediatric Hospital of AUSL 2-Lucca (Italy) for bacterial or viral infective diseases documented by cell culture or presumed diagnosed. Children with the following characteristics were excluded from the study: 1) blood samples collected for hemochrome analysis at times other than normal (7-8 a.m.); 2) cortisone treatment administered up to 5 days prior to blood sample and/or during hospitalisation; 3) positive personal anamnesis for manifest allergic diseases. On admittance (children during acute phase) and at the start of remission, an absolute count of circulating eosinophils was performed in these children using an automatic globule counter. Sixty-six children with non evident infective and/or inflammatory diseases were included in the study as a control group. This group was also selected in the same way as infective subjects.
The mean number of circulating eosinophils was 288 (+/- 248) in the control group, 46 (+/- 58) in subjects at the acute phase of infective pathology and 252 (+/- 162) in infective patient during the remission phase. The difference between the two means was statistically significant. This characteristic falling and rising trend of circulating eosinophils was found in 33 of the 34 infective subjects examined.
Eosinophil values found in control subjects are broadly in line with those reported in the literature. Eosinopenia during the course of acute infection and the early rise during remission represent a characteristic phenomenon indicating the body's "normal" response to a non-parasitic infection. Both eosinophil levels, namely in the control group (288/mm3) and in acute-phase subjects (46/mm3), should be regarded as "normal" provided they refer to the appropriate situation. The precocity and precision with which the eosinophil trend follows the phases of the infection underlines the value of the assay of these cells as a reliable parameter for monitoring acute infection. There are also indications that, in an inflammatory situation, the behaviour of circulating eosinophils may provide a practical clinical marker of the predominant lymphocyte pattern (Th1 or Th2), as well as the phase of phlogosis, active or remission.
急性细菌和病毒感染会伴随着血液中循环嗜酸性粒细胞显著减少。这是宿主对急性感染的生理反应的一部分，在本世纪初首次在成年人中进行研究。本研究的目的是检查急性炎症期间的嗜酸性粒细胞减少是否是儿科患者中存在的现象，以及这种趋势是否与所报道的实验模型相当；描述缓解过程中循环嗜酸性粒细胞的趋势。
对意大利卢卡省AUSL 2儿童医院收治的34例因细胞培养记录或疑似诊断的细菌或病毒感染性疾病住院的儿童进行回顾性研究。具有以下特征的儿童被排除在研究之外：1）在非正常时间（上午7 - 8点）采集用于血色素分析的血样；2）在血样采集前5天内和/或住院期间接受可的松治疗；3）有明显过敏性疾病的个人病史阳性。在入院时（急性期儿童）和缓解开始时，使用自动血细胞计数器对这些儿童进行循环嗜酸性粒细胞的绝对计数。66例无明显感染和/或炎症性疾病的儿童作为对照组纳入研究。该组的选择方式与感染组相同。
对照组循环嗜酸性粒细胞的平均数量为288（±248），感染性疾病急性期受试者为46（±58），缓解期感染患者为252（±162）。两组平均值之间的差异具有统计学意义。在所检查的34例感染性受试者中，有33例发现了循环嗜酸性粒细胞这种特征性的下降和上升趋势。
对照组中发现的嗜酸性粒细胞值与文献报道的大致相符。急性感染过程中的嗜酸性粒细胞减少以及缓解期的早期上升是一种特征性现象，表明身体对非寄生虫感染的“正常”反应。只要嗜酸性粒细胞水平参考适当的情况，无论是对照组（288/mm³）还是急性期受试者（46/mm³）的水平都应视为“正常”。嗜酸性粒细胞趋势跟随感染阶段的早熟性和精确性强调了检测这些细胞作为监测急性感染可靠参数的价值。也有迹象表明，在炎症情况下，循环嗜酸性粒细胞的行为可能提供一个实用的临床标志物，用于指示主要淋巴细胞模式（Th1或Th2）以及炎症阶段，即活动期或缓解期。
