哮喘及肺炎患儿外周血RANTES表达及临床意义探讨

Detection and Significance of the Expression of RANTES in Peripheral Blood in Children with Bronchial Asthma and Pneumonia

目的探讨RANTES在哮喘发病机制中的作用及其作为评价哮喘炎症指标的临床价值。方法收集36例哮喘急性发作患儿、37例肺炎患儿及25例健康儿血清,用ELISA法测定RANTES水平,采用逆转录-PCR技术各测定5例外周血单个核细胞中RANTESmRNA表达。结果①与健康儿相比肺炎、哮喘患儿的RANTESmRNA表达水平均升高,经统计学处理,肺炎无显著性差异(P>0.05),哮喘有非常显著差异(P<0.01),且哮喘和肺炎相比差异亦有非常显著性(P<0.01);②与健康儿相比肺炎、哮喘患儿血清RANTES水平均升高,差异有统计学意义(P≤0.01～0.05),哮喘和肺炎相比较亦有显著差异(P<0.05)。结论RANTES参与了哮喘的发病过程,其机制可能与它们能够激活炎症细胞有关。监测外周血RANTES基因和蛋白表达有助于哮喘诊断,并与肺炎合并喘息作出鉴别,从而指导临床诊断和治疗。

Objective To explore the roles for RANTES（reduced upon activation,normal T cell expressed and secreted） in the pathogenesis of bronchial asthma,and to evaluate the clinical values of these chemokines in the diagnosis of asthma.Methods Serum samples were obtained from 36 asthma,37 pneumonia and 25 healthy children.ELISA method was used to determine the concentratiom of RANTES. RANTES mRNA expression of PBMC in 5 asthma, 5pneumonia and 5healthy children was measured by reverse transcription - polymerase chain reaction. Results （1） There was marked increase in RANTES mRNA expression of PBMC in asthma than in pneumonia and healthy children（ P 〈 0.01）, while, RANTES mRNA expression of PBMC in pneumonia had no more statistical difference than that in healthy children （P〉 0.05）. （2）There were marked increase in RANTES levels of serum in asthma than that in pneumonia and healthy children （ P 〈 0.01）. The RANTES levels of serum in pneumonia were significantly higher than those in healthy children （ P 〈 0.05）. Conclusions RANTES are involved in the asthmatic process by activating inflammatory cells. Detection and significance of the expression of RANTES genes and proteins are helpful to diagnose asthma, and are helpful to diagnose differentially asthma from pneumonia with wheezing, further to guide clinical diagnosis and therapy.