小儿喘息性疾病下呼吸道感染急性期炎症介质临床变化
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摘要
目的分析小儿喘息性疾病患儿下呼吸道感染急性期炎症介质的临床改变状况。方法选取2016年6月至2018年6月在富县人民医院接受治疗的喘息性疾病患儿60例作为观察组,选取同期接受治疗的不伴喘息下呼吸道感染患儿50例作为对照组,选取同期在本院体检的健康幼儿50例作为健康组,采集三组受检者早晨空腹静脉血4 mL,ELISA法检测血清嗜酸性粒细胞阳离子蛋白(ECP)、CD62P及人白三烯(LTB4)含量,免疫比浊法检测超敏C反应蛋白(hs-CRP)含量。结果观察组和对照组患儿的血清CD62P含量分别为(6.60±0.43) ng/mL、(3.21±0.40) ng/mL,均明显高于健康组的(1.10±0.41) ng/mL,观察组又明显高于对照组,差异均有统计学意义(P<0.05);健康组、观察组和对照组患儿的血清ECP含量分别为(3.36±1.24) mg/L、(3.49±1.25) mg/L、(3.51±1.21) mg/L,差异无统计学意义(P>0.05);观察组和对照组患儿的血清hs-CRP和LTB4含量分别为(6.53±1.29) mg/L、(28.50±0.23) pg/mL和(6.45±1.31) mg/L、(11.36±0.25) pg/mL,均明显高于健康组的(3.34±1.20) mg/L、(0.86±0.21) pg/mL,观察组血清LTB4含量又明显高于对照组,差异均有统计学意义(P<0.05);观察组和对照组患儿的血清hs-CRP含量比较,差异无统计学意义(P>0.05)。结论下呼吸道感染急性期患儿的血清LTB4、hs-CRP及CD62P含量均显著升高,伴喘息症状患儿其体内气道及全身的炎症反应更为严重。
Objective To analyze the clinical changes of inflammatory mediators in the acute phase of lower respiratory tract infection in children with asthmatic disease. Methods Sixty children with asthmatic disease who were treated in Fuxian People's Hospital from June 2016 to June 2018 were enrolled as the observation group, 50 children with respiratory tract infection without respiratory tract were selected as the control group, and 50 healthy children in the hospital were collected as healthy group. Fasting venous blood(4 mL) was collected from three groups of subjects, and serum eosinophil cationic protein(ECP), CD62 P, and human leukotriene(LTB4) were detected by ELISA. The content of hypersensitive C-reactive protein(hs-CRP) was detected by immunoturbidimetry. Results Serum CD62 Plevels in the observation group and the control group were(6.60±0.43) ng/mL and(3.21±0.40) ng/mL, respectively, which were significantly higher than(1.10±0.41) ng/mL in the healthy group(P<0.05). The serum ECP levels in healthy, observation and control groups were(3.36±1.24) mg/L,(3.49±1.25) mg/L,(3.51±1.21) mg/L, respectively, respectively, and the difference was not statistically significant(P>0.05). The serum hs-CRP, and LTB4 levels were(6.53±1.29) mg/L, and(28.50±0.23) pg/mL in the observation group and(6.45±1.31) mg/L, and(11.36±0.25) pg/mL in the control group respectively,significantly higher than(3.34±1.20) mg/L, and(0.86±0.21) pg/mL in the healthy group, and the serum LTB4 level in the observation group was higher than that in the control group(P<0.05). There was no significant difference in serum hs-CRP between the observation group and the control group(P>0.05). Conclusion The serum levels of LTB4,hs-CRP, and CD62 Pin children with acute lower respiratory tract infection are significantly increased. The airway and systemic inflammatory reactions in children with wheezing symptoms are more serious.
Objective To analyze the clinical changes of inflammatory mediators in the acute phase of lower respiratory tract infection in children with asthmatic disease. Methods Sixty children with asthmatic disease who were treated in Fuxian People's Hospital from June 2016 to June 2018 were enrolled as the observation group, 50 children with respiratory tract infection without respiratory tract were selected as the control group, and 50 healthy children in the hospital were collected as healthy group. Fasting venous blood(4 mL) was collected from three groups of subjects, and serum eosinophil cationic protein(ECP), CD62 P, and human leukotriene(LTB4) were detected by ELISA. The content of hypersensitive C-reactive protein(hs-CRP) was detected by immunoturbidimetry. Results Serum CD62 Plevels in the observation group and the control group were(6.60±0.43) ng/mL and(3.21±0.40) ng/mL, respectively, which were significantly higher than(1.10±0.41) ng/mL in the healthy group(P<0.05). The serum ECP levels in healthy, observation and control groups were(3.36±1.24) mg/L,(3.49±1.25) mg/L,(3.51±1.21) mg/L, respectively, respectively, and the difference was not statistically significant(P>0.05). The serum hs-CRP, and LTB4 levels were(6.53±1.29) mg/L, and(28.50±0.23) pg/mL in the observation group and(6.45±1.31) mg/L, and(11.36±0.25) pg/mL in the control group respectively,significantly higher than(3.34±1.20) mg/L, and(0.86±0.21) pg/mL in the healthy group, and the serum LTB4 level in the observation group was higher than that in the control group(P<0.05). There was no significant difference in serum hs-CRP between the observation group and the control group(P>0.05). Conclusion The serum levels of LTB4,hs-CRP, and CD62 Pin children with acute lower respiratory tract infection are significantly increased. The airway and systemic inflammatory reactions in children with wheezing symptoms are more serious.
引文
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[11]任安义.外周血炎症介质对支气管哮喘并发呼吸道感染的早期诊断意义[J].中国实验诊断学, 2017, 21(6):1050-1052.
[12]苏慧霞.血清白介素-4和干扰素-γ及尿白三烯E4在婴幼儿喘息性疾病中的变化及意义[J].河北医药, 2016, 38(7):1031-1033.
[13] WANG L, KANG R, XIE JL, et al. Influence of ulinastatin on pulmonary surfactant protein, anti-inflammatory and pro-inflammatory mediator in patients with severe pneumonia[J]. Journal of Hainan Medical University, 2016, 22(7):304-307.
[14]刘苗,薛东生,姜毅.儿童喘息性疾病的临床研究进展[J].中华实用儿科临床杂志, 2016, 31(4):314-316.
[15]张艳,王伟. CD62P、CD54在呼吸道合胞病毒感染毛细支气管炎患儿外周血中的表达及意义[J].实用医学杂志, 2016, 32(7):1196-1197.
[16] TODI VK, LODHA R, KABRA SK. Effect of addition of single dose of oral montelukast to standard treatment in acute moderate to severe asthma in children between 5 and 15 years of age:a randomised,double-blind, placebo controlled trial[J]. Archives of Disease in Childhood, 2010, 95(7):540-543.
[2]陈飞红,余军平,陈赛.温岭地区儿童喘息性疾病的呼吸道病毒病原学研究[J].中国卫生检验杂志, 2016, 17(22):3230-3232.
[3]黄嘉婷,宋文秀.呼吸道合胞病毒感染后引发喘息性疾病的发病机制[J].中国妇幼保健, 2017, 32(5):1099-1101.
[4] TURNER S, MILLER D, WALSH GM, et al. Pro-inflammatory mediator responses from neonatal airway epithelial cells and early childhood wheeze[J]. Pediatric Pulmonology, 2017, 53(1):105-108.
[5]沈华浩,应英华.新版全球哮喘防治创议(GINA)方案的评价和解读[J].临床内科杂志, 2007, 24(4):221-223.
[6]胡亚美,江载芳.诸福棠实用儿科学[M].人民卫生出版社, 2002:216-219.
[7] ESPOSITO S, SOTOMARTINEZ ME, FELESZKO W, et al. Nonspecific immunomodulators for recurrent respiratory tract infections,wheezing and asthma in children:a systematic review of mechanistic and clinical evidence[J]. Current Opinion in Allergy Clinical Immunology, 2018, 18(3):198-209.
[8]蔡青,邓金强.婴幼儿喘息性疾病FeNO检测与sIgE、IgE的相关性分析[J].中国医药导报, 2017, 14(12):97-100.
[9] DI GS, SARDO C, CASTELLANI S, et al. From genesis to revelation:the role of inflammatory mediators in chronic respiratory diseases and their control by nucleic acid-based drugs[J]. Current Drug Delivery, 2016, 14(2):34-37.
[10]裴伦.儿童喘息性疾病中RSV与MP联合检测的意义及其与哮喘的关系[J].儿科药学杂志, 2018, 5(8):214-217.
[11]任安义.外周血炎症介质对支气管哮喘并发呼吸道感染的早期诊断意义[J].中国实验诊断学, 2017, 21(6):1050-1052.
[12]苏慧霞.血清白介素-4和干扰素-γ及尿白三烯E4在婴幼儿喘息性疾病中的变化及意义[J].河北医药, 2016, 38(7):1031-1033.
[13] WANG L, KANG R, XIE JL, et al. Influence of ulinastatin on pulmonary surfactant protein, anti-inflammatory and pro-inflammatory mediator in patients with severe pneumonia[J]. Journal of Hainan Medical University, 2016, 22(7):304-307.
[14]刘苗,薛东生,姜毅.儿童喘息性疾病的临床研究进展[J].中华实用儿科临床杂志, 2016, 31(4):314-316.
[15]张艳,王伟. CD62P、CD54在呼吸道合胞病毒感染毛细支气管炎患儿外周血中的表达及意义[J].实用医学杂志, 2016, 32(7):1196-1197.
[16] TODI VK, LODHA R, KABRA SK. Effect of addition of single dose of oral montelukast to standard treatment in acute moderate to severe asthma in children between 5 and 15 years of age:a randomised,double-blind, placebo controlled trial[J]. Archives of Disease in Childhood, 2010, 95(7):540-543.