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目的探讨长期吸入糖皮质激素对哮喘患儿粘附因子系统与补体激活片段的影响。方法采用酶联免疫吸附法(ELISA),检测了2002-01—2004-12于青岛大学医学院附属医院儿科就诊的26例哮喘患儿吸入糖皮质激素治疗前及治疗后3个月、6个月、12个月后血清细胞间粘附因子-1(sICAM-1)、血管内皮细胞粘附因子-1(sVCAM-1)和补体激活片段(sC5b-9)的质量浓度变化,并与28名健康儿童比较。结果哮喘患儿治疗前血清sICAM-1、sVCAM-1和sC5b-9质量浓度明显高于对照组;吸入糖皮质激素后血清sICAM-1、sVCAM-1和sC5b-9质量浓度逐渐下降,吸入时间越长,sICAM-1、sVCAM-1和sC5b-9质量浓度降低越明显;吸入糖皮质激素12个月后血清sICAM-1、sVCAM-1和sC5b-9质量浓度与正常对照组比较差异无显著性。结论粘附因子和补体激活片段在哮喘的发病中可能起了一定的作用。长时间吸入糖皮质激素可降低sICAM-1、sVCAM-1和sC5b-9的水平。测定血清sICAM-1、sVCAM-1和sC5b-9水平可用于吸入糖皮质激素抗炎疗效的判断,也可作为哮喘病情和治疗临床观察的指标。
Objective To investigate the effect of long-term inhaled corticosteroids on the adhesion factor system and complement activation fragments in asthmatic children. Methods Twenty-six asthmatic children with pediatric asthma treated by Department of Pediatrics, Affiliated Hospital of Qingdao University from January 2002 to December 2004 were tested by enzyme-linked immunosorbent assay (ELISA) before and after treatment with glucocorticoid 3 months and 6 months The changes of serum concentration of intercellular adhesion molecule-1 (sICAM-1), sVCAM-1 (sVCAM-1) and complement activation fragment (sC5b-9) A comparison of healthy children. Results The serum concentrations of sICAM-1, sVCAM-1 and sC5b-9 in asthmatic children before treatment were significantly higher than those in the control group. The concentrations of sICAM-1, sVCAM-1 and sC5b-9 in inhaled corticosteroids gradually decreased, The longer the concentration of sICAM-1, sVCAM-1 and sC5b-9, the more obvious the decrease of serum concentration of sICAM-1, sVCAM-1 and sC5b-9 after 12 months of inhaled glucocorticoid was no significant difference compared with the normal control group Sex. Conclusion Adhesion factors and complement activation fragments may play a role in the pathogenesis of asthma. Prolonged inhalation of glucocorticoids reduces the levels of sICAM-1, sVCAM-1 and sC5b-9. Determination of serum sICAM-1, sVCAM-1 and sC5b-9 levels can be used to determine the efficacy of inhaled glucocorticoid anti-inflammatory, but also as an indicator of asthma and clinical observation.