肺炎支原体肺炎和支气管哮喘患儿尿白三烯E4、血清白细胞介素4水平的变化及其意义

Changes in Levels of Urinary Leukotriene E4 and Serum Interleukin-4 in Children with Mycoplasma Pneumoniae Pneumonia and Bronchial Asthma and Their Significance

目的探讨肺炎支原体肺炎(mycoplasma pneumoniae pneumonia,MPP)和支气管哮喘(bronchial asthma,BA)患儿尿白三烯E4(leukotriene E4,LTE4)、血清白细胞介素4(interleukin-4,IL-4)水平的变化及其意义。方法采用竞争性酶联免疫吸附法(ELISA)检测20例急性期、恢复期MPP(MPP组)患儿和23例急性发作期、临床缓解期BA(BA组)患儿及21例健康体检的儿童(正常对照组)尿LTE4、血清IL-4的水平。结果 BA组、MPP组急性(发作)期尿LTE4、血清IL-4水平均较正常对照组明显升高(均P<0.01);BA组临床缓解期尿LTE4、血清IL-4水平较急性发作期下降(P<0.05),但高于正常对照组(P<0.05);MPP组恢复期尿LTE4、血清IL-4水平较急性期下降(P<0.05),尿LTE4、血清IL-4水平与正常对照组比较差异无统计学意义(P>0.05),MPP组临床缓解期/恢复期尿LTE4、血清IL-4水平低于BA组(P<0.05)。MPP组急性期尿LTE4水平与血清IL-4水平呈无相关(r=-0.139,P>0.05),BA组急性发作期尿LTE4水平与血清IL-4水平呈正相关(r=0.819,P<0.01)。结论 LTE4及IL-4可能共同参与MPP和BA急性期、急性发作期的气道炎症反应。BA恢复期、临床缓解期的血清IL-4、尿LTE4水平测定对MPP与BA的鉴别诊断可能有一定的帮助。

Objective To explore the changes in levels of urinary leukotriene E4（LTE4）and serum interleukin-4（IL-4） in children with mycoplasma pneumoniae pneumonia（MPP） and bronchial asthma（BA） and their significance.Methods The levels of urinary LTE4 and serum IL-4 were measured by ELISA in 20 children with acute（attack） and convalescence MPP（MPP group）,23 children with acute attack and clinical remission of BA（BA group）,and 21 healthy children（normal control group）.Results Compared with the normal control group,the levels of urinary LTE4 and serum IL-4 during acute（attack） stage significantly increased in both MPP group and BA group（all P0.01）.The levels of urinary LTE4 and serum IL-4 during remission in BA group were lower than those during acute attack（P0.05）,but higher than those in the normal control group（P0.05）.The levels of urinary LTE4 and serum IL-4 during convalescence in MPP group were lower than those during acute attack（P0.05）,but were not significantly different from normal control group（P0.05）,and the levels during remission/convalescence were lower than those in BA group（P0.05）.There was no correlation between urinary LTE4 levels and serum IL-4 levels in the acute stage in MPP group（r=-0.139,P0.05）,but urinary LTE4 levels were positively correlated with serum IL-4 levels during acute attack in BA group（r=0.819,P0.01）.Conclusion LTE4 and IL-4 may play important roles in pathogenesis of respiratory tract inflammation in children with MPP and BA in acute（attack） stages.The measurement of urinary LTE4 and serum IL-4 levels during remission and convalescence may be helpful to diagnose MPP and BA.