The Spectrum And Frequency Of Causes And Characteristics Of Airway Inflammatory In NEB And CVA Patients

ObjectiveTo investigate The spectrum and frequency of causes for eosinophilic bronchitis (NEB)and(CVA).And the features of air way inflammation in patients by analyzing the inflammatory cells and mediator sP in induced sputum.MethodsSputum induced by hypertonic saline aerosol inhalation was collected in 28 patients with NEB(NEB group),24 patients with cough variant asthma(CVA group), 17 patients with bronchial asthma(asthma group) and 15 healthy controls(healthy group) from October 2007 to October 2008,all of which were all out-patients of respiration clinic service.The informed consents were filled by every single patient. Differential cell counts and the level of sP were measured in each sputum sample. Statistical analysis was done by SPSS13.0:the results were expressed as mean±SEM(SE).The significance of differences between means was assessed by the H-test and U-test for comparisons,with statistical significance judged as p＜0.01.ResultsThe frequency of causes of NEB and CVA were 10.4%(28/270) and 17.8%(48/270) respectively.Average of sputum eosinophils(EOS) have showed significant difference among the four groups:healthy group0.53±0.83,NEB group7.57±3.11,CVA group18.17±14.96,asthma group 30.71±21.58(P＜0.01). The difference between asthma group and CVA group and the difference between CVA group and NEB group were significant(P＜0.05).The concentration of sputum sP was 0.72±0.16μg/ml in NEB group,0.93±0.52μg/ml in CVA group,1.38±0.62μg/ml in asthma group and 0.44±0.16μg/ml in healthy group.It showed significant difference when asthma group was compared with NEB group and CVA group(P＜0.05),but there was no difference between NEB group and CVA group(P＞0.05).Sputum sP had significant positive correlations with eosinophil counts in sputum(r=0.601,p＜0.01).ConclusionThe spectrum and frequency of causes for chronic cough maybe related to climate and geographical features.Airway inflammation of CVA and NEB are characterized by eosinophil infiltration as asthma.EOS is the feature of asthma and can release many mediators of inflammation.These mediators can interact with airway epithelial cells directly or indirectly.EOS infiltration can reflect the severity of airway inflammation. Patients with NEB or CVA have gentled symptoms may be related to the levels of infiltrated EOS.The concentration of sputum sP was significantly decreased when healthy group was compared with NEB group,CVA group and asthma group, especially in asthmatic group,indicating that sP concentration maybe one of the reasons that gasping is rarely seen in NEB and CVA.Sputum eosinophil counts and sP are related to air way hyperreactivity,and may cause graping.Compared with the bronchial mucosa biopsies and BALF,sputum examination is non-invasive,economic, simple,easy to accept and repeatable.The mediators in the sputum can reflect the severity of airway inflammation directly,which shows important diagnostic value in the desease.