哮喘患儿cAMP/cGMP平衡的研究及心先安对其的调节作用

Clinical significance of plasma cAMP/cGMP ratio in children with asthma and therapetltic effect of the meglumine cycle adenylate in of bronchial asthma.

【目的】探讨支气管哮喘患儿血浆环磷酸腺苷（cAMP）/磷酸鸟苷（cGMP）比值变化及其临床意义,以及心先安治疗支气管哮喘的疗效。【方法】①采用特异性放射免疫分析法检测22例哮喘患儿急性期和缓解期外周血浆cAMP、cGMP表达水平,并以24例正常儿童作对照。②采用特异性放射免疫分析法检测接受常规治疗和心先安治疗（每次2.5-5.0 mg/kg,每日1-2次,连续7 d）的19例哮喘患儿外周血浆cAMP、cGMP表达水平,以接受常规治疗的22例哮喘患儿作对照。【结果】①哮喘患儿急性期外周血浆cGMP水平高于缓解期和正常组（P〈0.05）,而cAMP水平和cAMP/cGMP水平低于缓解期和正常组（P〈0.05）;②予心先安治疗的哮喘患儿外周血浆cAMP水平和cAMP/cGMP水平高于对照组（P〈0.05）,而cGMP水平低于对照组（P〈0.05）。【结论】①哮喘患儿cGMP表达亢进,cAMP表达不足。cAMP/cGMP平衡失调,可作为监测和指导哮喘治疗的生化指标;②哮喘患儿给予心先安治疗能够纠正cAMP/cGMP失衡,疗效较好。

[Objective] To investigate the clinical significance of the ratio of plasma cyclic adernosine monophosphate/cyclic guanosine monophosphate in children with asthma and therapeutic effects of meglumine cycle adenylate medication. [Methods] The level of cAMP/cGMP in peripheral plasma of 22 children with asthma, in acute stage and cata basis was detected by specific radioimmunoassay. Meanwhile 24 sex and age matched healthy children serve as the control. For those 19 children with meglumine cyclic adenosine taken （once 2.5-5.0 mg/kg,qd or bid for consecutive 7 days）and 22 control patients receiving required treatment,peripherial plasma gathered for the measurement of cAMP/cGMP. [Results] The level of cGMP of peripheral plasma in children with asthma of acute stage was significantly higher than that of the catabasis and the control（both P〈0. 05） ,while the level of plasma cAMP lower（ both P〈0.05）. The ratio of cAMP/ cGMP in peripheral plasma of children with asthma of acute stage was statistically different form that of the catabasis and the control（both P〈0. 05）. With meglumine cyclic adenosine administrated in the acute stage, elevated plasma level of cAMP and the ratio of cAMP/cGMP was detected,and decreased cGMP as well（P〈0.05）. [Conclusions] Overexpression of plasma cGMP and insufficiency of cAMP consist in children with asthma,and the ratio of cAMP/cGMP can serve as a biochemical target for monitoring and directing the treatment of asthma, meglumine cyclic adenosine medication is beneficient for the balance of cAMP/cGMP and the control of asthma.