毛细支气管炎病后的P物质和气道反应性检测与哮喘发病关系的研究

The relationship between substance P, airway reactivity and development of asthma after bronchiolitis

目的 探讨毛细支气管炎与儿童哮喘的关系。方法 对５０ 例毛细支气管炎患儿于病后５ 年作远期随访，应用放射免疫法测定其中３０ 例的血浆Ｐ物质浓度，并以超声雾化蒸馏水激发试验测定气道反应性。结果 ５０ 例中有１８ 例（３６％ ） 发展为哮喘；毛细支气管炎组血浆Ｐ物质浓度为（３１５±８０） ｐｍｏｌ／Ｌ，对照组３０ 例为（２３４ ±２３） ｐｍｏｌ／Ｌ，两组相比较差异有显著意义（ｔ′＝ ５．２１９５，Ｐ＜０．０５） ；超声雾化蒸馏水激发试验显示毛细支气管炎组７ 例阳性，而对照组全部阴性，组间差异有显著意义（ Ｐ＝ ０．００５２７） 。结论 毛细支气管炎患儿病后哮喘的发生率达３６％ ，部分患儿尚存在血浆Ｐ物质浓度增高和气道高反应性。

Objective To evaluate possible relationship between substance P, airway reactivity and development of asthma after bronchiolitis Methods Fifty cases with a history of bronchiolitis were followed up 5 years after suffering from the disease Among them, the concentration of substance P (SP) was measured by radioimmunoassary, and the airway reactivity was evaluated by ultrasonic nebulized distilled water (UNDW) test in 30 cases and 30 healthy controls Results Eighteen out of 50 cases (36%) developed asthma, the level of SP concentration was 315±80 pmol/L in children with a history of bronchiolitis, and 234±23 pmol/L in healthy controls( P <0 05) Seven out of 30 cases were positive on UNDW test and none of healthy controls was positive ( P <0 05 ) Conclusion There were an increased morbidity of asthma, an abnormal concentration of SP in plasma and higher airway reactivity in children with a history of bronchiolitis It is very important to prevent and monitor children with history of bronchiolitis for diagnosing and treating asthma effectively