尿白三烯E4检测在监测儿童支气管哮喘转归中的应用

Application of Urinary Leukotriene E4 Detection in Monitoring Outcome of Children with Bronchial Asthma

目的探讨尿白三烯E4(LTE4)检测在监测儿童支气管哮喘(哮喘)转归中的作用及哮喘患儿尿LTE4与呼吸道阻力(Rint)、外周血嗜酸性粒细胞(EOS)计数的关系。方法选取30例1～5岁未服用过白三烯受体拮抗剂孟鲁司特钠的哮喘患儿(哮喘组),分为急性发作期、慢性持续期(服用孟鲁司特钠1个月)及临床缓解期(服用孟鲁司特钠3个月);另选取20例健康儿童作为健康对照组。采用竞争性ELISA法检测4组儿童尿LTE4水平,并测定Rint与EOS。结果哮喘组急性发作期、慢性持续期及临床缓解期患儿尿LTE4及Rint水平均明显高于健康对照组(Pa<0.01);3个哮喘组尿LTE4、Rint及外周血EOS比较差异均有统计学意义(F=870.08、496.58、195.98,Pa<0.01)。急性发作期哮喘患儿的尿LTE4水平与Rint无相关性(r=0.11,P>0.05),与EOS亦无相关性(r=-0.12,P>0.05)。结论哮喘患儿急性发作期尿LTE4水平明显升高,随着哮喘症状的好转,尿LTE4水平也逐渐下降;动态监测哮喘患儿尿LTE4水平,可以为儿童哮喘的临床诊断、白三烯受体拮抗剂治疗哮喘的疗效评估提供客观依据。

Objective To explore the role of urinary leukotriene E4（LTE4） detection in monitoring the outcome of children with bronchial asthma（asthma） and the relationships between urinary LTE4 and airway resistance（Rint）,peripheral blood eosinophils（EOS） counted. Methods Thirty asthmatic children aged 1-5 years who had never taken leukotrienes receptor antagonist-montelukast were selected as asthmatic group,and they were divided into acute attack period group,chronic duration group in which the patients had taken montelukast for 1 month,clinical remission group in which the patients had taken montelukast for 3 months.At the same time,20 healthy children were selec-ted as healthy control group.Urinary LTE4 was measured by competitive enzyme linked immunosorbent assay,Rint and EOS were also determined in these children. Results Urinary LTE4 and Rint of asthmatic children in acute attack stage group,chronic duration group and clinical remission group were significantly higher than those in healthy control group（Pa〈0.01）.Urinary LTE4,Rint and peripheral EOS in 3 asthmatic group were significantly different（F=870.08,496.58,195.98;Pa〈0.01）.In acute attack period,there was no correlation between urinary LTE4 and Rint（r=0.11,P〉0.05）,and there was also no correlation between urinary LTE4 and EOS（r=-0.12,P〉0.05）. Conclusions Urinary LTE4 in acute attack period was significantly increased,along with upturn of asthma,urinary LTE4 decreased gradually;Urinary LTE4 is an useful marker in guiding asthma diagnosis and treatment of leukotriene receptor antagonists.