呼吸道合胞病毒毛细支气管炎患儿血和痰中白三烯测定及临床意义

The blood and sputum levels of leukotriene in children with respiratory syncytial viral bronchiolitis

目的探讨呼吸道合胞病毒（respiratory syncytial virus，RSV）毛细支气管炎（毛支炎）患儿血、痰中自三烯C4（1eukotriene C4，LTC4）水平的变化及临床意义。方法轻一中度毛支炎组22例，重度毛支炎组11例，另选择无喘息非RSV感染性肺炎患儿12例作为对照（肺炎组）。采用双抗体夹心酶联免疫吸附试验测定血清和痰中LTC4水平，并进行对比分析。结果急性期轻-中度毛支炎组、重度毛支炎组、肺炎组血清LTC4水平分别为（76．96±28．19）pg／ml、（103．53±16．85）pg／ml、（18．14±7．49）pg／ml；痰中LTC4水平分别为（31．83±19．14）pg／ml、（67．11±15．11）pg／ml、（6．81±2．90）pg／ml；恢复期血清LTC4水平分别为（36．04±16．38）pg／ml、（52．27±17．03）pg／ml、（18．14±7．49）pg／ml，3组间差异有统计学意义（F=48．09，P〈0．001；F=15．50，P〈0．001；F=44．43，P〈0．001）。治疗后轻一中度和重度毛支炎组血清LTC4水平明显降低，但仍高于肺炎组，差异有统计学意义（P〈0．05）。结论RSV毛支炎患儿血和痰中LTC4水平明显增高，并与病情的轻重相关。

Objective To investigate the effects of leukotriene in children with respiratory syncytial （RSV） viral bronchiolitis. Methods The blood and sputum levels of leukotriene were detected in 33 cases diagnosed RSV bronchiolitis and 12 cases which were diagnosed pneumonia without RSV infection. Thirty-three cases of bronchiolitis were devided into mild-moderate group（n =22） and severe group（n = 11 ） according to the lowell score. Results The blood and sputum levels of leukotriene in mild-moderate group, severe group, and pneumonia group were （ 76. 96 ± 28.19 ） pg/ml, （ 103.53 ± 16. 85 ） pg/ml, （ 18.14± 7.49 ） pg/ml; （31.83±19.14） pg/ml, （67.11±15.11） pg/ml, （6.81±2.90） pg/ml in acute period, and （36.04±16. 38 ） pg/ml, （ 52. 27±17.03 ） pg/ml, （ 18. 14 ± 7.49 ） pg/ml of serum in recovery period. There were significant differences among three groups （ F = 48.09, P 〈 0. 001 ; F = 15.50, P 〈 0. 001 ; F = 44.43, P 〈 0. 001 ）. After treatment, the blood levels of leukotriene were significantly decreased, but were still higher than that of pneumonia group （ P 〈 0. 05 ）. Conclusion The blood and sputum levels of leukotriene increase in children with RSV bronchiolitis, which is related with the severity of bronchiolitis.