长期吸入糖皮质激素对哮喘患儿粘附因子系统与补体激活片段的影响

Influence of long-term inhaled glucocorticoids on adhesion molecular system and complement activated fragment of bronchial asthmatic children

目的探讨长期吸入糖皮质激素对哮喘患儿粘附因子系统与补体激活片段的影响。方法采用酶联免疫吸附法(ELISA),检测了2002-01—2004-12于青岛大学医学院附属医院儿科就诊的26例哮喘患儿吸入糖皮质激素治疗前及治疗后3个月、6个月、12个月后血清细胞间粘附因子-1(sICAM-1)、血管内皮细胞粘附因子-1(sVCAM-1)和补体激活片段(sC5b-9)的质量浓度变化,并与28名健康儿童比较。结果哮喘患儿治疗前血清sICAM-1、sVCAM-1和sC5b-9质量浓度明显高于对照组;吸入糖皮质激素后血清sICAM-1、sVCAM-1和sC5b-9质量浓度逐渐下降,吸入时间越长,sICAM-1、sVCAM-1和sC5b-9质量浓度降低越明显;吸入糖皮质激素12个月后血清sICAM-1、sVCAM-1和sC5b-9质量浓度与正常对照组比较差异无显著性。结论粘附因子和补体激活片段在哮喘的发病中可能起了一定的作用。长时间吸入糖皮质激素可降低sICAM-1、sVCAM-1和sC5b-9的水平。测定血清sICAM-1、sVCAM-1和sC5b-9水平可用于吸入糖皮质激素抗炎疗效的判断,也可作为哮喘病情和治疗临床观察的指标。

Objective To research the influence of long-term inhaled glucocorticoids on adhesion molecular system and complement activated fragment of bronchial asthmatic children. Methods Through enzyme-linked immunosorbent Assay （ ELISA ） , the the serum sICAM-1, sVCAM-1 and sCSb-9 levels were compared in 28 healthy pupils （ normal control group） ,26 asthmatic children （un-inhaled glucocorticoids group） and asthmatic children after inhaled glucocorticoids （Igs） 3,6 and 12 months. Results Serum sICAM-1 ,sVCAM-1 and sCSb-9 levels were significantly elevated in children with asthma. The levels of sICAM-1 ,sVCAM-1 and sCSb-9 in children with asthma were decreased gradually after inhaled glucocorticoids for 3,6 and 12 months, and differed significantly compared with un-inhaled group. There was no significant difference of the serum sICAM-1 and sVCAM-1 level in the 12-month group compared with that of normal control group. Conclusion Adhesion molecular system and complement activated fragment may play an important role in asthma. Longterm inhaled glucocorticoids can inhibit asthma by lowering the serum sICAM-1 ,sVCAM-1 and sCSb-9 level, sICAM-1, sVCAM-1 and sCSb-9 level may be an marker of therapeutic effect of Inhaled Glucocorticoids.