目的：研究诱导痰中过敏毒素C3a在支气管哮喘发病中的变化特点及临床意义。方法自2006年9月~2007年2月于我院呼吸科门诊和病房就诊的哮喘急性发作期患者共33例，收集其人口学资料、病史及家族史、肺功能数据及诱导痰中C3a水平，进行分析和总结。结果（1）哮喘急性发作期诱导痰中C3a水平[2.24（1.68~5.58）ng/ml]高于治疗后哮喘临床缓解期C3a水平[0.7（0.24~2.31）ng/ml]（P<0.01），哮喘临床缓解期C3a水平高于对照组[0.12（0.07~0.39）ng/ml]（P<0.05）；（2）哮喘急性发作期，诱导痰C3a水平随轻度急性发作[0.25（0.09~0.40）ng/ml]、中度急性发作[2.21（1.16~3.41）ng/ml]、重度急性发作[4.69（2.69~6.59）ng/ml]依次升高，且存在明显差异（P<0.01）；（3）哮喘急性发作期组患者诱导痰C3a水平与诱导痰细胞总数呈正相关（r=0.718, P<0.05），嗜酸性粒细胞计数呈正相关（r=0.495, P<0.05），巨噬细胞计数呈正相关（r=0.600, P<0.05）。结论诱导痰C3a水平与哮喘严重程度和局部炎症细胞学分类相关，可能成为重要的临床标志物指导哮喘的治疗。
Objective To investigate the clinical significance of anaphylatoxin C3a in induced sputum in patients with asthma. Methods The patients with acute exacerbation of asthma treated at our department between September, 2006 and February, 2007 were included in the study. The demographic data, medical history, levels of lung function and C3a levels in induced sputum were assessed. Results A total of 33 patients were included in the study. The level of C3a in induced sputum was significantly higher in patients with acute exacerbation of asthma (2.24 ng/ml, range 1.68-5.58 ng/ml) than that in patients with asthma remission (0.7 ng/ml, range 0.24-2.31 ng/ml, P<0.05). Sputum C3a levels in the remission patients were significantly higher than those in the healthy controls (0.12 ng/ml, range 0.07-0.39 ng/ml, P<0.05). The levels of C3a in patients with severe exacerbation (4.69 ng/ml, range 2.69-6.59 ng/ml) were significantly higher than those in patients with mild exacerbation (0.25 ng/ml, range 0.09-0.40 ng/ml) and moderate exacerbation (2.21 ng/ml, range 1.16-3.41 ng/ml) (P<0.01), and were significantly higher in patients with moderate exacerbation than in those in mild exacerbation (P<0.01). The level of C3a in induced sputum was positively correlated with the number of total cell count (r=0.718, P<0.05), eosinophils (r=0.495, P<0.05) and macrophages (r=0.600, P<0.05) in patients with acute exacerbation of asthma. Conclusion Induced sputum C3a level can serve as an important clinical biomarker for clinical asthma management.