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[摘要] 目的 探讨儿童慢性荨麻疹伴AD患儿血浆脂氧素A4水平，分析其与疾病严重程度的相关性。 方法 选取2012年6月～2014年6月我院收治慢性荨麻疹患儿36例、AD患儿32例、慢性荨麻疹伴AD患儿31例，正常对照患儿30例，采集患者外周静脉血分离血浆，应用ELISA法测定血浆脂氧素A4的含量，分析脂氧素A4与疾病严重程度SCORAD评分的相关性。 结果 AD组及慢性荨麻疹伴AD组血浆脂氧素A4水平均低于正常对照组（P<0.05），血浆脂氧素A4水平与SCORAD评分呈负相关（r=-0.386，P<0.05）。慢性荨麻疹组血浆脂氧素A4水平与正常对照组差异无统计学意义（P>0.05）。 结论 脂氧素A4水平的降低可能参与慢性荨麻疹伴AD疾病发生。
[关键词] 慢性荨麻疹；AD；脂氧素；SCORAD
[中图分类号] R758.2 [文献标识码] A [文章编号] 1673-9701（2015）23-0005-03
Change of lipoxin A4 level in patients with chronic urticaria associated with AD and its clinical significance
JIN Wanwan1 YU Suting1 ZHOU Pengfei1 LI Qiongying1 ZHAO Qifeng2 GAO Yu1
1.Department of Dermatology， Second Affiliated Hospital of Wenzhou Medical University/Yuying Children’s Hospital， Wenzhou 325000， China； 2.Department of Dermatology， Second Affiliated Hospital of Wenzhou Medical University/Yuying Children’s Hospital， Wenzhou 325000， China
[Abstract] Objective To investigate the plasma lipoxin A4 level in children with chronic urticaria associated with AD and analyze its correlation to the severity. Methods Thirty-six patients with chronic urticaria， 32 patients with AD， 31 patients with chronic urticaria associated with AD and 30 normal control patients who were treated in our hospital from June 2012 to June 2014 were selected. The patients’ peripheral venous blood was collected for plasma separation. The ELISA method was used to measure the content of plasma lipoxin A4. The correlation between the plasma lipoxin A4 level and the SCORAD score indicating severity of disease was analyzed. Results The plasma lipoxin A4 level of both the AD group and the chronic urticaria associated with AD group were higher than the normal control group（P<0.05）， and the plasma lipoxin A4 level was in a negative correlation to the SCORAD score（r=-0.386， P<0.05）. The plasma lipoxin A4 level of chronic urticaria group was not significantly different from the normal control group（P>0.05）. Conclusion The reduction of plasma lipoxin A4 level may involve in the occurrence of chronic urticaria associated with AD.
[Key words] Chronic urticaria； AD； Lipoxin； SCORAD
慢性荨麻疹和特应性皮炎（atopic dermatitis，AD）是常见的慢性变态反应性皮肤病，由各种炎症介质参与，其中白三烯在疾病发展过程中扮演着重要角色[1]。脂氧素A4（lipoxin A4）和白三烯C4都是花生四烯酸的代谢产物，脂氧素是拮抗白三烯的天然物质，发挥广泛的抗炎促消退作用，其代谢异常是多种炎症相关疾病失控性发展的关键机制。本研究旨在测定慢性荨麻疹及AD患儿血浆脂氧素A4水平，分析脂氧素A4 与疾病严重程度的关系，现报道如下。
1 资料与方法
1.1 一般资料
选取我院2012年6月～2014年6月临床确诊为慢性荨麻疹的36例患儿为慢性荨麻疹组，在试验前24 h有荨麻疹的症状和体征，男17例，女19例，平均年龄（5.8±1.9）岁，病程2～34个月。符合以下条件：①病程≥6周；②处于病情活动期，风团每天发作或几乎每天发作。根据诊断标准选择临床上确诊为AD患儿32例为AD组，男17例，女15例，平均年龄（6.3±2.0）岁，15分≤SCORAD≤67分。另选择慢性荨麻疹伴AD患儿31例为慢性荨麻疹伴AD组，荨麻疹病程3～39个月，15分≤SCORAD≤62分。对照组为30例正常体检儿童，平均年龄（6.9±2.1）岁。各组年龄及性别等一般资料比较差异无统计学意义（P>0.05），具有可比性。排除标准：患有心脏病、严重肝肾功能不全、血液系统疾病、自身免疫性疾病、慢性感染、恶性肿瘤的患儿；2周内服用过抗组胺药、抗胆碱能药、受体激动剂、阿司匹林类药及糖皮质激素。在试验期间，家长/监护人均签署知情同意书。 1.2 方法
血浆中脂氧素A4浓度的检测：采用酶联免疫吸附试验（ELISA）检测血浆中脂氧素A4水平，ELISA试剂盒为美国R
[关键词] 慢性荨麻疹；AD；脂氧素；SCORAD
[中图分类号] R758.2 [文献标识码] A [文章编号] 1673-9701（2015）23-0005-03
Change of lipoxin A4 level in patients with chronic urticaria associated with AD and its clinical significance
JIN Wanwan1 YU Suting1 ZHOU Pengfei1 LI Qiongying1 ZHAO Qifeng2 GAO Yu1
1.Department of Dermatology， Second Affiliated Hospital of Wenzhou Medical University/Yuying Children’s Hospital， Wenzhou 325000， China； 2.Department of Dermatology， Second Affiliated Hospital of Wenzhou Medical University/Yuying Children’s Hospital， Wenzhou 325000， China
[Abstract] Objective To investigate the plasma lipoxin A4 level in children with chronic urticaria associated with AD and analyze its correlation to the severity. Methods Thirty-six patients with chronic urticaria， 32 patients with AD， 31 patients with chronic urticaria associated with AD and 30 normal control patients who were treated in our hospital from June 2012 to June 2014 were selected. The patients’ peripheral venous blood was collected for plasma separation. The ELISA method was used to measure the content of plasma lipoxin A4. The correlation between the plasma lipoxin A4 level and the SCORAD score indicating severity of disease was analyzed. Results The plasma lipoxin A4 level of both the AD group and the chronic urticaria associated with AD group were higher than the normal control group（P<0.05）， and the plasma lipoxin A4 level was in a negative correlation to the SCORAD score（r=-0.386， P<0.05）. The plasma lipoxin A4 level of chronic urticaria group was not significantly different from the normal control group（P>0.05）. Conclusion The reduction of plasma lipoxin A4 level may involve in the occurrence of chronic urticaria associated with AD.
[Key words] Chronic urticaria； AD； Lipoxin； SCORAD
慢性荨麻疹和特应性皮炎（atopic dermatitis，AD）是常见的慢性变态反应性皮肤病，由各种炎症介质参与，其中白三烯在疾病发展过程中扮演着重要角色[1]。脂氧素A4（lipoxin A4）和白三烯C4都是花生四烯酸的代谢产物，脂氧素是拮抗白三烯的天然物质，发挥广泛的抗炎促消退作用，其代谢异常是多种炎症相关疾病失控性发展的关键机制。本研究旨在测定慢性荨麻疹及AD患儿血浆脂氧素A4水平，分析脂氧素A4 与疾病严重程度的关系，现报道如下。
1 资料与方法
1.1 一般资料
选取我院2012年6月～2014年6月临床确诊为慢性荨麻疹的36例患儿为慢性荨麻疹组，在试验前24 h有荨麻疹的症状和体征，男17例，女19例，平均年龄（5.8±1.9）岁，病程2～34个月。符合以下条件：①病程≥6周；②处于病情活动期，风团每天发作或几乎每天发作。根据诊断标准选择临床上确诊为AD患儿32例为AD组，男17例，女15例，平均年龄（6.3±2.0）岁，15分≤SCORAD≤67分。另选择慢性荨麻疹伴AD患儿31例为慢性荨麻疹伴AD组，荨麻疹病程3～39个月，15分≤SCORAD≤62分。对照组为30例正常体检儿童，平均年龄（6.9±2.1）岁。各组年龄及性别等一般资料比较差异无统计学意义（P>0.05），具有可比性。排除标准：患有心脏病、严重肝肾功能不全、血液系统疾病、自身免疫性疾病、慢性感染、恶性肿瘤的患儿；2周内服用过抗组胺药、抗胆碱能药、受体激动剂、阿司匹林类药及糖皮质激素。在试验期间，家长/监护人均签署知情同意书。 1.2 方法
血浆中脂氧素A4浓度的检测：采用酶联免疫吸附试验（ELISA）检测血浆中脂氧素A4水平，ELISA试剂盒为美国R