【作者】 刘焕；

【导师】 何庆南；

【作者基本信息】 中南大学 ， 儿科学， 2008， 硕士

【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B₄和尿液白三烯E₄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B₄、尿液白三烯E₄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B₄浓度（单位pg/ml）分析:喘息组急性期血清白三烯B₄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B₄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B₄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B₄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E₄浓度（单位pg/ml）分析:喘息组急性期尿液白三烯E₄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E₄浓度显著下降,喘息缓解期尿液白三烯E₄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E₄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E₄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E₄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B₄浓度与尿液白三烯E₄浓度相关性分析:血清白三烯B₄浓度与尿液白三烯E₄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（LTB₄和LTE₄）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。更多还原

【Abstract】 Objective:To detect serum of cysteinyl leukotriene B₄（LTB₄）and urine of cysteinyl leukotriene E₄（LTE₄）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 LTB₄ and LTE₄ 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 LTB₄ 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）.LTB₄ 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 LTE₄ concentration:Concentration of LTE₄ 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 LTE₄ decreased significantly,in asthma remission,the concentration of LTE₄ 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）,LTE₄ 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 LTB₄ concentration and urine LTE₄ concentration was positively correlated（γ=0.742,P＜0.05）.Conclusion:Concentration of cysteinyl leukotriene B₄ and cysteinyl leukotriene E₄ in infants with asthmatic diseases maintained a high level. Leukotrienes is one of the major factors that led to the infants wheezing episode.更多还原