婴幼儿毛细支气管炎血清瘦素水平的变化与预后探讨

Relation between serum leptin levels and the prognosis of in infantile bronchiolitis

【目的】探讨血清瘦素(leptin,LEP)水平与婴幼儿毛细支气管炎患儿Th1/Th2细胞平衡及预后的关系。【方法】47例初次喘息发作并确诊为婴幼儿毛细支气管炎患者分别于入院后24 h内、治疗结束及出院后12周用放射免疫法检测血清LEP水平,并随访1年,进行前瞻性研究。根据患儿喘息发作的情况,分为婴儿哮喘组和非哮喘组;另选10例健康儿童血清标本作对照。【结果】共有19例患者出院后再次喘息发作并诊断为婴幼儿哮喘,占40.4%。与正常儿童比较,毛细支气管炎患儿血清IFN-γ水平降低、IL-4及LEP水平升高(P<0.05);出院时及出院12周后复查,哮喘组血清LEP水平高于非哮喘组和对照组(P<0.05),而非哮喘组血清LEP水平逐渐下降至对照组水平(P>0.05)。【结论】婴幼儿毛细支气管炎患者发生哮喘者血清LEP水平较健康同龄儿童及非哮喘儿童明显升高,持续高LEP水平可能是婴幼儿毛细支气管炎患者发生婴儿哮喘的高危因素之一。

[Objective] To investigate the relationship among serum leptin（LEP） levels, the balance regulation of Th1/Th2 cell and the prognosis in development into asthma in infantile bronchiolitis. [Methods] 47 cases of the initial wheezing attack infants diagnosed as bronchiolitis were given blood samples to detect serum levels of LEP with radioimmunoassay （RIA） within 24 h after admission, discharged and 12 weeks later respectively. Follow up for 1 year,prospective was carried out. According to the situation of children with wheezing episodes, they were divided into asthma group and non-asthma group; 10 cases of serum samples of healthy children were served as controls. [Results] 40. 4% infants developed into asthma in the selected group after 1 year later. Compared with control group, IFN-7 levels in infants with bronchiolitis were lower than those of the healthy children, but higher in IL-4 and LEP levels（P〈0.05）. When they were discharged or even 12 weeks after discharged, LEP levels in the asthma group were significantly higher than those in nonasthma group and control group （P〈0.05）, LEP levels in non asthma group gradually decreased to the level of the control group （P〉0.05）. [Conclusions] LEP levels in infants with asthma are higher than those in healthy and non-asthma children. Persistent higher level of LEP may be a risk factor in developing into asthma for infants with bronchiolitis.