血浆肾上腺髓质素和尾加压素Ⅱ动态变化在毛细支气管炎中的临床意义

Plasma adrenomedullin and urotensin II concentrations in children with capillary bronchitis

目的探讨毛细支气管炎患儿急性期和恢复期血浆肾上腺髓质素（ADM）及尾加压素Ⅱ（U-Ⅱ）变化的临床意义。方法选择153例毛细支气管炎患儿和36名健康对照儿童，测定患儿急性期（病程〈7d）及恢复期（病程〉14d）血浆ADM和U—Ⅱ水平，分析与疾病症状评分的相关性。结果患儿急性期血浆ADM和U—Ⅱ水平均高于恢复期和健康对照儿童（血浆ADM：t=20．57和26．26，P〈O．01；血浆U—Ⅱ：t=14．27和7．61，P〈0．01），且疾病不同严重程度患儿间也存在明显差异（F=245．94和304．79，P值均〈0．01）。恢复期患儿血浆U-Ⅱ水平低于健康对照儿童（t=6．99，P〈0．01），但ADM水平仍高于对照组（t=8．98，P〈0．01），疾病不同严重程度患儿间血浆ADM水平相近（F=2．25，P〉0．05），而U-Ⅱ水平比较则差异具有统计学意义（F=25．69，P〈0．01）。毛细支气管炎患儿急性期症状评分与血浆ADM和U-Ⅱ水平呈正相关（r值分别为0．884和0．943，P值均为0．000）；恢复期症状评分与血浆ADM和U-Ⅱ水平虽在统计学上P值小于0．05，但相关系数较小，因此实际意义不大。结论毛细支气管炎患儿急性期血浆ADM和u-Ⅱ均显著升高，水平与患者病情呈正相关，提示ADM和U-Ⅱ参与了毛细支气管炎的发病，可作为毛细支气管炎严重程度的参考指标之一。

Objective To evaluate the plasma levels of adrenomedullin （ADM） and urotensin Ⅱ （ U- Ⅱ ） in children with capillary bronchiolitis, and their clinical significance. Methods One hundred and fifty three children with capillary bronchiolitis and 36 healthy children were recruited. Plasma levels of ADM and U-l] were measured at acute stage （ 〈 7 days） and convalescent stage （ 〉 14 days） of airway inflammation. The relationship of plasma ADM and U- Ⅱ levels with symptom scores was evaluated. Results Plasma levels of ADM and U-Ⅱ in acute stage of capillary bronchiolitis were significantly higher than those in convalescent stage and healthy controls （ ADM ： t = 20. 57 and 26. 26, P 〈 0. 01 ; U- Ⅱ ： t = 14. 27 and 7. 61, P 〈 0. 01 ）, and there were significant differences among mild, moderate and severe capillary bronchiolitis （ F = 245.94 and 304.79, P 〈 0.01 ）. Plasma level of U- Ⅱ in convalescent stage of capillary bronchiolitis was lower than that of healthy controls （ t = 6. 99, P 〈 0. 01 ）, but ADM was still in a higher level （ t = 8. 98, P 〈 0.01 ）. In the convalescent stage, there was significant difference on U- Ⅱ levels among mild, moderate and severe capillary bronchiolitis （F = 25.69, P 〈 0.01 ）, but no significant difference was observed for ADM levels （ F = 2. 25, P 〉 0. 05 ）. Plasma levels of ADM and U-Ⅱ in acute stage showed positive correlation with symptom scores, and the regression coefficients were 0. 884 （ P = 0. 000 ） for ADM and 0. 943 （ P= 0. 000 ） for U- Ⅱ. Conclusion Plasma ADM and U-Ⅱ levels in children with capillary bronehiolitis are increased in acute stage and correlated with the symptom scores, which may serve as laboratory indicators for assessing the severity of the disease.