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目的测定呼吸道合胞病毒(RSV)毛细支气管炎患儿尿白三烯E4(LTE4)水平,探讨其在RSV毛细支气管炎发病中的作用。方法选取40例毛细支气管炎患儿,免疫荧光法检测其鼻咽分泌物RSV抗原均阳性,作为RSV毛细支气管炎组;根据临床资料进行评分,将其分为轻度组(n=24)和中度组(n=16)。30例健康儿童为健康对照组。RSV毛细支气管炎患儿分别于急性期(入院24h)、恢复期(入院治疗7d后)留取尿液各10mL,健康对照组亦留取晨起尿液10mL,采用竞争性ELISA法检测尿LTE4水平。结果健康对照组尿LTE4水平[中位数,四分位数间距(M,Q)]为1.28pmol·mmol-1、1.72pmol·mmol-1,RSV毛细支气管炎患儿急性期尿LTE4水平(M,Q)为30.52pmol·mmol-1、23.56pmol·mmol-1,恢复期尿LTE4水平(M,Q)为3.98pmol·mmol-1、3.43pmol·mmol-1。毛细支气管炎患儿急性期尿LTE4较健康儿童明显增高(P<0.01),急性期尿LTE4明显高于恢复期(P<0.01),而恢复期尿LTE4水平与健康对照组比较差异无统计学意义(P>0.05)。轻度组尿LTE4水平(M,Q)为19.26pmol·mmol-1、13.67pmol·mmol-1,中度组尿LTE4水平(M,Q)为46.52pmol·mmol-1、20.33pmol·mmol-1,二组比较差异有统计学意义(P<0.05)。结论 RSV毛细支气管炎患儿尿LTE4明显增高,可作为RSV毛细支气管炎临床诊治的非创伤性炎性指标。白三烯参与毛细支气管炎的发病过程,白三烯受体拮抗剂在RSV毛细支气管炎治疗上可能有一定作用。
Objective To determine the level of urinary leukotriene E4 (LTE4) in children with respiratory syncytial virus (RSV) bronchiolitis and to explore its role in the pathogenesis of RSV bronchiolitis. Methods Forty children with bronchiolitis were selected and immunostained for RSV antigens of nasopharyngeal secretions. The RSV antigens were detected as RSV bronchiolitis group. According to the clinical data, they were divided into mild group (n = 24) and mild group Moderate group (n = 16). 30 healthy children as healthy control group. RSV bronchiolitis children were collected in the acute phase (admission 24h), convalescence (admission 7d after admission) the urine of 10mL, the healthy control group also took the morning urine 10mL, using competitive ELISA assay urine LTE4 Level. Results The urinary LTE4 levels (median, interquartile range (M, Q)] in patients with RSV bronchiolitis were 1.28 pmol · mmol-1 and 1.72 pmol · mmol- M, Q) was 30.52 pmol · mmol-1, 23.56 pmol · mmol-1, and the recovery phase urinary LTE4 level (M, Q) was 3.98 pmol · mmol-1, The level of LTE4 in children with bronchiolitis was significantly higher than that in healthy children (P <0.01), and the level of LTE4 in acute phase was significantly higher than that in recovery (P <0.01). However, there was no statistical difference between the two groups Significance (P> 0.05). The mild group had LTE4 levels (M, Q) of 19.26 pmol · mmol-1 and 13.67 pmol · mmol-1, moderate group urinary LTE4 levels of 46.52 pmol · mmol-1 and 20.33 pmol · mmol- 1, the difference between the two groups was statistically significant (P <0.05). Conclusions The urine LTE4 of children with RSV bronchiolitis is significantly increased, which may serve as a noninvasive inflammatory index for clinical diagnosis and treatment of RSV bronchiolitis. Leukotriene is involved in the pathogenesis of bronchiolitis. Leukotriene receptor antagonists may play a role in the treatment of RSV bronchiolitis.