哮喘患儿诱导痰Clara细胞分泌蛋白与嗜酸性粒细胞阳离子蛋白检测的意义

Clinical Significance of Induced Sputum Clara Cell Secretory Protein and Eosinophil Cationic Protein in Children with Bronchial Asthma

目的探讨Clara细胞分泌蛋白（CCSP）与嗜酸性粒细胞阳离子蛋白（ECP）在儿童支气管哮喘发病机制中的作用,评价其反映哮喘呼吸道炎症的价值。方法本院哮喘专科患儿31例。男18例,女13例;年龄3.7-12.0岁,平均7.6岁;均按全球哮喘防治创议（GINA）方案系统吸入糖皮质激素治疗,在慢性持续期和临床缓解期分别留取诱导痰标本。用酶联免疫吸附法（ELISA）测定CCSP水平,以Pharmacia UniCAP系统检测ECP水平。结果哮喘慢性持续期患儿诱导痰CCSP质量浓度明显低于临床缓解期（P〈0.001）,而ECP水平明显高于临床缓解期（P〈0.001）,且二者之间呈负相关（r=-0.676P〈0.001）。结论CCSP在哮喘的发病过程中起抗炎作用,而ECP起促炎作用,同时监测诱导痰CCSP、ECP的变化,可较好地反映呼吸道炎症情况,评价疗效及预后。

Objective To explore the roles of clara cell secretory protein （CCSP） and eosinophil cationic protein（ECP） in the pathogenesis of bronchial asthma and to evaluate their diagnostic value in asthmatic children. Methods Induced sputum samples were obtained from 31 asthmatic children during chronic persistent period and clinical remission period. According to global initiative for asthma（ GINA）, the total of 31 cases accepted systemic treatment by inhaling glucocorticoid. The patients included 18 boys and 13 girls aged from 3.7 to 12.0 years, and their average age was 7.6 years. Sputum CCSP concentrations were measured by enzyme - linked immunosorbent assay（ ELISA）. And the concentrations of sputum ECP were determined with Pharmacia UniCAP system. Results Asthmatic children had significantly lower CCSP levels in sputum during chronic persistent period compared with clinical remission period （ P 〈 0.001 ）. However, sputum ECP levels in children within chronic persistent period were higher than that in clinical remission period （ P 〈 0.001 ）. There were significantly negative correlation between CCSP and ECP concentrations （ r = - 0. 676 P 〈 0.001 ）. Conclusions CCSP may play a protective role in the pathogenesis of asthma, while ECP can accelerate inflammation in the airway. To detect induced sputum, CCSP and ECP levels may be helpful to reflect the state of inflammation in airway and the effect of anti - inflammation therapy and prognosis.