婴幼儿喘息性疾病血、尿白三烯浓度变化及其意义研究
摘要
目的:检测和动态观察喘息患儿及非喘息患儿血清白三烯B_4和尿液白三烯E_4浓度,探讨白三烯与婴幼儿喘息的关系,及其与肺炎支原体、呼吸道合胞病毒感染和婴幼儿特应性体质的关系。
方法:喘息组:2007年12月～2008年3月因喘息住院的婴幼儿(年龄＜3岁)30例,排除心源性哮喘,支气管异物及大气道梗阻等原因引起的喘息;非喘息对照组:同期住院的非喘息呼吸道感染婴幼儿(年龄＜3岁)20例;两组在年龄、性别上无显著性差异,入组前均未使用白三烯调节剂。收集喘息组喘息发作期血、尿标本,以及喘息缓解期尿液标本;收集对照组患儿入院时血、尿标本。标本收集后均离心后冷冻保存,采用ELISA法检测各组血白三烯B_4、尿液白三烯E_4水平。同时测定喘息组血清MP-IgM和RSV-IgM。应用SPSS13.0软件就上述结果进行统计分析。
结果:
1.喘息组30例患儿中,MP-IgM阳性4例,占13.3%;RSV-IgM阳性12例,占40%;MP-IgM和RSV-IgM同时阳性1例,占3.3%。
2.各组别血清白三烯B_4浓度(单位pg/ml)分析:喘息组急性期血清白三烯B_4浓度显著高于非喘息组(262.06±70.55 vs 197.10±45.43,P＜0.05)。在喘息组中,MP感染患儿血清白三烯B_4浓度显著高于非MP感染患儿(348.48±107.18 vs 248.76±54.91,P＜0.05);而RSV感染患儿与非RSV感染患儿血清白三烯B_4浓度差异无统计学意义(268.07±36.41 vs259.48±81.63,P＞0.05);特应性体质患儿血清白三烯B_4浓度显著高于非特应性体质患儿(323.04_+87.43 vs 235.92±42.04,P＜0.05)。
3.各组别尿液白三烯E_4浓度(单位pg/ml)分析:喘息组急性期尿液白三烯E_4浓度显著高于非喘息组(247.17±83.40 vs 128.43±46.150,P＜0.05)。随着喘息的缓解,喘息组病例尿液白三烯E_4浓度显著下降,喘息缓解期尿液白三烯E_4浓度明显低于喘息组急性期(177.44±43.86 vs247.17±83.40,P＜0.05),但仍然高于非喘息组病例(177.44±43.86 vs128.43±46.15,P＜0.05)。喘息组中,MP感染患儿尿液白三烯E_4浓度显著高于非MP感染患儿(409.92±100.47 vs 244.44±49.59,P＜0.05)而RSV感染与非RSV感染患儿尿液白三烯E_4浓度差异无统计学意义(262.06±45.74 vs 243.65±98.02,P＞0.05);特应性体质患儿尿液白三烯E_4浓度显著高于非特应性体质患儿(336.76±89.64 vs 211.63±49.05,P＜0.05)。
4.血清白三烯B_4浓度与尿液白三烯E_4浓度相关性分析:血清白三烯B_4浓度与尿液白三烯E_4浓度成正相关关系(γ=0.742,P＜0.05)。
结论:喘息性疾病婴幼儿体内白三烯(LTB_4和LTE_4)浓度呈持续增高的状态,其可能是导致婴幼儿喘息的重要原因之一。
Objective:To detect serum of cysteinyl leukotriene B_4(LTB_4)and urine of cysteinyl leukotriene E_4(LTE_4)concentration in infants with asthmatic diseases,and to explore the relationship with asthmatic diseases,pneumonia mycoplasma(MP),respiratory syncytial virus(RSV),and infants atopic status.
Methods:There were 30 infants with asthmatic diseases in the study group,and 20 infants with non-asthmatic diseases but with respiratory tract infection in the control group.Serum and urine samples were collected. Concentration of LTB_4 and LTE_4 in those samples were measured by enzyme linked immunosorbent assay(ELISA).Serum Mp-IgM and RSV-IgM were also analyzed by ELISA.The results were analyzed by SPSS 13.0.
Results:
1.MP-IgM positive 4 cases(13.3%),RSV-IgM positive 12 cases(40%), MP-IgM and RSV-IgM both positive 1 case(3.3%).
2.Analysis of LTB_4 concentration:That in asthmatic group was higher than that in non-asthmatic group(262.06±70.55 vs 197.10±45.43,P＜0.05).That in MP-IgM positive group was higher than that of MP-IgM negative group(348.48±107.18 vs 248.76±54.91,P＜0.05),but RSV-IgM positive group and RSV-IgM negative group had no significant difference(268.07±36.41 vs 259.48±81.63,P＞0.05).LTB_4 level in infants in asthmatic diseases group with atopic background group was higher than that of non-atopic status infants (323.04±87.43 vs 235.92±42.04,P＜0.05).
3.Analysis of LTE_4 concentration:Concentration of LTE_4 in acute asthma period was higher than that of non-asthmatic group(247.17±83.40 vs 128.43±46.150,P＜0.05),with the ease of asthma,the concentration of LTE_4 decreased significantly,in asthma remission,the concentration of LTE_4 was lower than that of acute asthma period(177.44±43.86 vs 247.17±83.40,P＜0.05),but was still higher than that of non-asthmatic group(177.44±43.86 vs 128.43±46.15,P＜0.05).In the asthmatic group,MP-IgM positive group was higher than that of MP-IgM negative group(409.92±100.47 vs 244.44±49.59,P＜0.05),but there were no significant difference between RSV-IgM positive group and RSV-IgM negative group(262.06±45.74 vs 243.65±98.02,P＞0.05),LTE_4 level in infants in asthmatic diseases group with atopic background group was higher than that of non-atopic status infants (336.76±89.64 vs 211.63±49.05,P＜0.05).
4.Serum LTB_4 concentration and urine LTE_4 concentration was positively correlated(γ=0.742,P＜0.05).
Conclusion:Concentration of cysteinyl leukotriene B_4 and cysteinyl leukotriene E_4 in infants with asthmatic diseases maintained a high level. Leukotrienes is one of the major factors that led to the infants wheezing episode.
方法:喘息组:2007年12月～2008年3月因喘息住院的婴幼儿(年龄＜3岁)30例,排除心源性哮喘,支气管异物及大气道梗阻等原因引起的喘息;非喘息对照组:同期住院的非喘息呼吸道感染婴幼儿(年龄＜3岁)20例;两组在年龄、性别上无显著性差异,入组前均未使用白三烯调节剂。收集喘息组喘息发作期血、尿标本,以及喘息缓解期尿液标本;收集对照组患儿入院时血、尿标本。标本收集后均离心后冷冻保存,采用ELISA法检测各组血白三烯B_4、尿液白三烯E_4水平。同时测定喘息组血清MP-IgM和RSV-IgM。应用SPSS13.0软件就上述结果进行统计分析。
结果:
1.喘息组30例患儿中,MP-IgM阳性4例,占13.3%;RSV-IgM阳性12例,占40%;MP-IgM和RSV-IgM同时阳性1例,占3.3%。
2.各组别血清白三烯B_4浓度(单位pg/ml)分析:喘息组急性期血清白三烯B_4浓度显著高于非喘息组(262.06±70.55 vs 197.10±45.43,P＜0.05)。在喘息组中,MP感染患儿血清白三烯B_4浓度显著高于非MP感染患儿(348.48±107.18 vs 248.76±54.91,P＜0.05);而RSV感染患儿与非RSV感染患儿血清白三烯B_4浓度差异无统计学意义(268.07±36.41 vs259.48±81.63,P＞0.05);特应性体质患儿血清白三烯B_4浓度显著高于非特应性体质患儿(323.04_+87.43 vs 235.92±42.04,P＜0.05)。
3.各组别尿液白三烯E_4浓度(单位pg/ml)分析:喘息组急性期尿液白三烯E_4浓度显著高于非喘息组(247.17±83.40 vs 128.43±46.150,P＜0.05)。随着喘息的缓解,喘息组病例尿液白三烯E_4浓度显著下降,喘息缓解期尿液白三烯E_4浓度明显低于喘息组急性期(177.44±43.86 vs247.17±83.40,P＜0.05),但仍然高于非喘息组病例(177.44±43.86 vs128.43±46.15,P＜0.05)。喘息组中,MP感染患儿尿液白三烯E_4浓度显著高于非MP感染患儿(409.92±100.47 vs 244.44±49.59,P＜0.05)而RSV感染与非RSV感染患儿尿液白三烯E_4浓度差异无统计学意义(262.06±45.74 vs 243.65±98.02,P＞0.05);特应性体质患儿尿液白三烯E_4浓度显著高于非特应性体质患儿(336.76±89.64 vs 211.63±49.05,P＜0.05)。
4.血清白三烯B_4浓度与尿液白三烯E_4浓度相关性分析:血清白三烯B_4浓度与尿液白三烯E_4浓度成正相关关系(γ=0.742,P＜0.05)。
结论:喘息性疾病婴幼儿体内白三烯(LTB_4和LTE_4)浓度呈持续增高的状态,其可能是导致婴幼儿喘息的重要原因之一。
Objective:To detect serum of cysteinyl leukotriene B_4(LTB_4)and urine of cysteinyl leukotriene E_4(LTE_4)concentration in infants with asthmatic diseases,and to explore the relationship with asthmatic diseases,pneumonia mycoplasma(MP),respiratory syncytial virus(RSV),and infants atopic status.
Methods:There were 30 infants with asthmatic diseases in the study group,and 20 infants with non-asthmatic diseases but with respiratory tract infection in the control group.Serum and urine samples were collected. Concentration of LTB_4 and LTE_4 in those samples were measured by enzyme linked immunosorbent assay(ELISA).Serum Mp-IgM and RSV-IgM were also analyzed by ELISA.The results were analyzed by SPSS 13.0.
Results:
1.MP-IgM positive 4 cases(13.3%),RSV-IgM positive 12 cases(40%), MP-IgM and RSV-IgM both positive 1 case(3.3%).
2.Analysis of LTB_4 concentration:That in asthmatic group was higher than that in non-asthmatic group(262.06±70.55 vs 197.10±45.43,P＜0.05).That in MP-IgM positive group was higher than that of MP-IgM negative group(348.48±107.18 vs 248.76±54.91,P＜0.05),but RSV-IgM positive group and RSV-IgM negative group had no significant difference(268.07±36.41 vs 259.48±81.63,P＞0.05).LTB_4 level in infants in asthmatic diseases group with atopic background group was higher than that of non-atopic status infants (323.04±87.43 vs 235.92±42.04,P＜0.05).
3.Analysis of LTE_4 concentration:Concentration of LTE_4 in acute asthma period was higher than that of non-asthmatic group(247.17±83.40 vs 128.43±46.150,P＜0.05),with the ease of asthma,the concentration of LTE_4 decreased significantly,in asthma remission,the concentration of LTE_4 was lower than that of acute asthma period(177.44±43.86 vs 247.17±83.40,P＜0.05),but was still higher than that of non-asthmatic group(177.44±43.86 vs 128.43±46.15,P＜0.05).In the asthmatic group,MP-IgM positive group was higher than that of MP-IgM negative group(409.92±100.47 vs 244.44±49.59,P＜0.05),but there were no significant difference between RSV-IgM positive group and RSV-IgM negative group(262.06±45.74 vs 243.65±98.02,P＞0.05),LTE_4 level in infants in asthmatic diseases group with atopic background group was higher than that of non-atopic status infants (336.76±89.64 vs 211.63±49.05,P＜0.05).
4.Serum LTB_4 concentration and urine LTE_4 concentration was positively correlated(γ=0.742,P＜0.05).
Conclusion:Concentration of cysteinyl leukotriene B_4 and cysteinyl leukotriene E_4 in infants with asthmatic diseases maintained a high level. Leukotrienes is one of the major factors that led to the infants wheezing episode.
引文
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