哮喘患儿血清sICAM-1、TNF-α与最大呼气流速的关系及其临床意义

Study on serun sICAM-1,TNF-α,PEF levels and clinical inplication in asthmatic children.

目的 探讨哮喘患儿血清可溶性细胞间粘附分子 - 1(s ICAM- 1)、肿瘤坏死因子 - α(TNF- α)与最大呼气流速(PEF)的关系、临床意义及激素治疗对它们的影响。方法 分离哮喘发作期、缓解期患儿和健康对照组儿童血清 ,用双抗体夹心酶联免疫吸附试验 (EL ISA)法测定血清 s ICAM- 1、TNF- α水平 ,用微型峰流速仪测 PEF,并对其中 12例应用激素治疗前后各指标作比较。结果 1发作期哮喘患儿血清 s ICAM- 1、TNF- α分别显著高于缓解期和对照组 (P<0 .0 1或 <0 .0 5 ) ,PEF值发作期显著低于缓解期和对照组。 2哮喘发作期患儿血清 TNF- α与 s ICAM- 1水平成正相关 ;PEF值分别与 s ICAM- 1和TNF- α水平呈负相关。 3患儿血清 s ICAM- 1和 TNF- α激素治疗前分别高于治疗后 ,PEF则相反。结论 1ICAM- 1和 TNF-α在哮喘气道炎症形成中起重要作用 ,与 PEF均可作为临床监测哮喘病情的指标。2激素能有效地抑制 ICAM- 1和 TNF- α的表述 ,从而起到抗炎、防治哮喘的作用。

Objective To investigate the correlation between serum sICAM 1,TNF α levels and PEF in asthmatic children and clinical implication and the effect of glucocorticoid on the above indices.Methods The sera were obtained from children with asthma and normal control children.sICAM 1,TNF α levels were assayed by using double antibody ELISA.PEF was measured by using mini peak expiratory flow instrument.The above indices before and after glucocorticoids treatment in 12 cases were compared.Results Serum sICAM 1 and TNF α levels in children during asthma attacks were significantly higher than those in remission stage and normal conrol group,respectively (P<0 01 or P<0 05).PEF levels in asthmatic children during attacks were significantly lower than those in remission stage and control group (P<0 05 or P<0 01). Du ring asthma attacks,serum,TNF α levels were positively correlated with serum sICAM 1,while PEF levels negatively with serum sICAM 1 and TNF α levels,respectively.Serum sICAM 1 and TNF α were significantly higher before corticoseroids treatment than those after the treatment,while PEF levels were evidently lower before the treatment than those after that.Conclusion ICAM 1 and TNF α might piay an important roie in rormation or alrway inriammation in astnma.Serum ICAM 1,TNF α and PEF can serve as effective indices for monitoring severity of asthma in clinical practice.Corticosteroids can effectively inhibit expression of ICAM 1 and TNF α,which play an action of anti inflammation and prevention and treatment of asthma.