支气管哮喘患者唾液褪黑素和皮质醇水平及其与病情的关系

Relationships between melatonin and cortisol and the status of disease in patients with bronchial asthma

目的 探讨基础状态与轻度、中 重度持续支气管哮喘 (简称哮喘 )患者唾液中褪黑素和皮质醇水平及其与病情严重程度的关系和临床意义。方法 收集哮喘患者 2 0例 ,其中轻度持续哮喘患者 10例 (A组 )、中 重度持续哮喘患者 10例 (B组 )和正常对照组 15名 (C组 )。采用放射免疫分析法检测受试者唾液中游离褪黑素和皮质醇含量。昼夜 2 4h按 8个时间点采集唾液标本 ,取样时白天为室内自然光 ,夜间光照强度控制在 50勒克司 (Lux)之内。结果 轻度和中 重度持续哮喘患者唾液中游离褪黑素水平分别为 (15 5± 5 3 ) μg/L和 (7 1± 2 5) μg/L ,与正常对照组 [(2 8 9± 8 7) μg/L]比较 ,差异有显著性 (F =4 47,P <0 0 5;F =7 61,P <0 0 1) ;轻度和中 重度持续哮喘患者唾液中游离皮质醇水平分别为 (3 1± 0 5) μg/L和 (4 2± 0 5) μg/L ,与正常对照组 [(5 9± 0 7) μg/L]比较 ,差异有显著性 (F =10 45,P <0 0 1;F =5 2 1,P <0 0 5) ,皮质醇振幅明显减小伴皮质醇分泌峰值相位显著后移 (P <0 0 5、<0 0 1) ;对照组和轻度持续哮喘患者唾液中褪黑素和皮质醇水平之间无相关性 (r=0 174,P =0 0 57;r =-0 13 8,P =0 2 2 1) ,中 重度持续哮喘患者的褪黑素和皮质醇水平之间呈显著负相关 (r =-0

ObjectiveThe aim of the study was to elucidate the interaction and clinical significance between melatonin and cortisol and the status of disease in patients with bronchial asthma. MethodsTen mild persistent and 10 moderate-to-severe persistent asthma patients were recruited to participate in the study. Fifteen normal subjects served as contrds Salivary free melatonin and cortisol were measured simultaneously by radioimmunoassay in all subjects, and 8 salivary samples were collected in a series during a 24-hour period in each subject. The intensity of light was restricted to natural light at room during the daytime and less than 50 lux at night. Results The results showed that salivary free melatonin levels were significantly lower in mild (15.5±5.3)μg/L and moderate-to-severe (7.1±2.5) μg/L persistent asthma patients as compared to control subjects (28.9±8.7)μg/L ( F= 4.47, P<0.05;F=7.61, P<0.01,respectively). The results also showed that salivary free cortisol levels were significantly lower in mild (3.1±0.5) μg/L and moderate-to-severe (4.2±0.5) μg/L persi stent asthma patients as compared to control subjects (5.9±0.7) μg/L (F=10.45, P<0.01; F=5.21, P<0.05, respectively). The amplitude of salivary free cortisol level was reduced in mild and moderate-to-severe persistent asthma patients, and salivary cortisol peak level was significantly delayed in mild and moderate-to-severe persistent asthma patients ( BXP<0.05, P<0.01, respectively). There were no significant correlations between the salivary free melatonin and cortisol levels in control and mild persistent asthma patients ( r=0.174, P=0.057; r=-0.138, P=0.221, respectively). However, a significant negative correlation was found between the salivary free melatonin and cortisol levels in moderate-to-severe persistent asthma patients ( r=-0.275, P= 0.013). Conclusions There were lower salivary free melatonin and cortisol levels in asthmatic patients. A significant negative correlation was found between melatonin and cortisol levels in moderate-to-severe persistent asthma patients Furthermore, the reciprocal inhibition of melatonin and cortisol was closely associated with the status of disease in asthmatic patients.