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目的：通过分析经纤维支气管镜肉眼观察哮喘病人气道炎症和临床表现以及气道粘膜组织中炎性细胞的关系，以了解肉眼观察哮喘病人气道炎症的特点。方法：采用Dahl肉眼评分系统对受试对象气道炎症进行积分后，钳取气道粘膜组织，利用HE染色结合免疫组化染色方法计数气道粘膜的各种炎性细胞，比较哮喘组与对照组之间差异，分析哮喘病人Dahl计分、气道粘膜炎性细胞计数和临床病情分级之间的关系。结果：①哮喘组Dahl积分为7．35±0．88，明显高于对照组1．06±0．36（P＜0．05），哮喘组Dahl积分与病情程度呈正相关（r＝0．73，P＜0．05）；②哮喘组气道粘膜嗜酸性粒细胞（17．9±23．3）×102／mm2，明显高于对照组（1．9±2．1）×102／mm2（P＜0．05）；哮喘组气道粘膜EG2阳性（活化分泌状态的嗜酸性细胞）细胞数（8．9±9．5）×102／mm2，明显高于对照组（0．8±0．8）×102／mm2，并且EG2阳性细胞数与病情程度相关（r＝0．65，P＜0．05）；③未发现哮喘组Dahl积分与粘膜组织的炎性细胞计数有显著相关性。结论：经纤维支气管镜对哮喘病人气道的肉眼评价是一种宏观视察气道炎症的客观指标，能够准确地反映哮喘病情程度。
OBJECTIVE: To observe the characteristics of airway inflammation in asthmatic patients visually by analyzing the relationship between airway inflammation and clinical manifestations of asthmatic patients and the inflammatory cells in airway mucosa by fiberoptic bronchoscopy. Methods: The airway inflammation was integrated by Dahl’s macroscopic scoring system, airway mucosa was dissected, and various inflammatory cells in airway mucosa were counted by HE staining and immunohistochemical staining. The differences between groups were analyzed for the relationship between Dahl score, airway mucosal inflammatory cell count and clinical grade in asthma patients. Results: ① The Dahl score of asthma group was 7.35 ± 0.88, significantly higher than that of control group 1.06 ± 0.36 (P <0.05). The Dahl score of asthma group was positively correlated with the severity of illness (r = 0. 73, P <0.05). ② The number of eosinophils (17.9 ± 23.3) × 102 / mm2 in the asthmatic group was significantly higher than that in the control group (1.9 ± 2.1) × 102 / mm2 (P <0.05). The number of EG2 positive cells (8.9 ± 9.5) × 102 / mm2 in the airway mucosa of asthma group was significantly higher than that of the control group (0.8 ± 0.8) × 102 / mm2, and the number of EG2-positive cells correlated with the severity of the disease (r = 0.65, P <0.05); ③ The Dahl score and mucosal inflammatory cell count were not found in the asthma group Correlation. Conclusion: The visual evaluation of airway by bronchofibroscopy in asthmatic patients is a macroscopic objective indicator of airway inflammation, which can accurately reflect the severity of asthma.