儿童哮喘α_1-抗糜蛋白酶杂合缺失研究

Study of heterozygous deficiency of α_1-antichymotrypsin in childhood asthma

目的探讨α1 抗糜蛋白酶(α1 antichymotrypsin,α1 ACT)杂合缺失是否为儿童哮喘发病的遗传因素。方法应用火箭免疫电泳技术检测90例哮喘儿童、180例健康儿童及200例健康成人血浆α1 ACT含量 ,家系调查确定α1 ACT杂合缺失 ,统计学方法分析α1 ACT杂合缺失和非缺失患儿的有关临床资料。结果哮喘组、儿童对照组以及成人对照组α1 ACT杂合缺失频率依次为4.4 %、0、0.05 % ,哮喘组较成人对照组明显增高[Prevalenceradio(PR)=8.89, 2MH =5.68,95 %置信区间(1.47,53.60) ,P<0.05] ;且α1 ACT杂合缺失患儿哮喘初发年龄早、住院次数多、放射性过敏原吸附试验阳性率显著增高[PR=3.91, 2MH=10.190,95 %置信区间(1.69,9.03) ,P<0.01]。结论α1 ACT杂合缺失与儿童哮喘发病及其严重性存在一定的联系。

Objective To investigate whether heterozygous deficiency of α1-antichymotrpsin (α1-ACT) is a factor of the pathogenesis of childhood asthma. Methods 90 children with childhood asthma, 180 healthy children and 200 healthy adults were examined for serum level of α1-ACT with rocket immunoelectrophoresis. Heterozygous deficiency of α1-ACT was determined on the basis of family history. The clinical materials of asthmatic children with or without heterozygous α1-ACT deficiency were analyzed statistically. Results The rate of heterozygous deficiency of α1-ACT was 4.4% in childrenn with childhood asthma, 0% in healthy children and 0.5% in healthy adults. The rate of heterozygous deficiency of α1-ACT was far higher in the asthmatic children than in healthy adults (Prevalence ratio=8.89, 2MH=5.68, 95% confidence interval 1.47, 53.60, P< 0.05). The children with heterozygous deficiency of α1-ACT experienced the first onset of asthma in a far younger age and were hospitalized more frequently. And they had a higher positive rate of radioactive sensitizin test (Prevalence ratio=3.91,2MH=10.190,95% confidence interval 1.69,9.03,P<0.01). Conclusion These findings suggest that there is a possible association of heterozygous deficiency of α1-ACT with childhood asthma and with the severity of childhood asthma to some degree.