摘要
为探索儿童反复呼吸道感染(RRTI)与下呼吸道粘膜纤毛结构异常的关系 ,以及RRTI患儿下呼吸道粘膜纤毛结构异常的发生率 ,并比较原发性和继发性纤毛异常的不同超微结构表现 ,对符合RRTI诊断标准住院患儿进行支气管粘膜活检 ,电镜观察其纤毛超微结构。结果显示 ,47例RRTIs患儿中支气管纤毛柱状上皮细胞结构异常38例(80.9%) ,其中22例(46.8%)为纤毛超微结构异常 ,16例(34.1%)为早期鳞状上皮化生 ;支气管粘膜结构正常9例 (19.1% )。结合临床 ,11例(23.4%)初步诊断为原发纤毛运动障碍 ,其中2例为Kartagener综合征 ;27例(57.4%)诊断为继发性纤毛上皮结构损害。在观察到的8种纤毛超微结构异常表现中 ,原发性和继发性患儿的发生率存在一定差别 ,但无显著统计学差异(P>0.05)。提示下呼吸道纤毛结构异常是儿童RRTIs的病因之一 ,约半数患儿存在支气管纤毛结构异常 ;在RRTIs患儿中大多数纤毛上皮细胞损伤为继发性 。
To study the correlation between RRTI and the abnormality of the cilia ultrastructure in the lower respiratory tract mucosa,the incidence of these abnormality and compare the different patterns of the ultrastructure in children with primary and secondary cilia ultrastructure,bronchial mucosa biopsies were performed and cilia ultrastructure was observed under electron microscopy on 47 admitted children who were in concordance with the unified diagnosis criteria for children with RRTI.The results showed 38 of 47 cases(80.9%) had the bronchial cilia cylindrical epithelium abnormalities with 22 of them (46.8%) having the cilia ultrastructure abnormality,16 of them(34.1%)in early stage of squamous metaplasia and 9 of them (19.1%) with normal ultrastructure.Primary cilia dyskinesia was diagnosed in combination with the clinical features in 11 cases(23.4%),2 of them were diagnosed as Kartagener's syndrome whereas 27 of them(57.4%)were dia_ gnosed as the secondary cilia epithelium ultrastructure abnormality.There existed some differences in the incidence of primary and secondary diseases in the 8 kinds of cilia ultrastructure abnormal patterns with no marked statistical difference(P>0.05),indicating that abnormalilty of the lower respiratory ciliary ultra_ structure was one of the pathogenesis in children with RRTI.About half of the RRTI patients had the abnormality of the bronchial ciliary ultrastructure with majority of them having secondary ciliary epithelium injury.The incidence of primary ciliary dyskinesia was significantly higher in children with RRTI than that in the general population.
出处
《临床儿科杂志》
CAS
CSCD
北大核心
2003年第9期535-538,共4页
Journal of Clinical Pediatrics
