呼吸道合胞病毒毛细支气管炎患儿炎症递质的变化

Mediators of inflammation in children with respiratory syncytial virus bronchiolitis

目的研究气道炎症递质鼻咽分泌物嗜酸粒细胞阳离子蛋白(NPS-ECP)和尿白三烯E4(LTE4)在呼吸道合胞病毒(RSV)毛细支气管炎患儿体内的变化。方法 120例RSV检测阳性毛细支气管炎住院患儿,分为特应性组和非特应性组;同时选取30名健康体检儿童作为对照组。以酶联免疫吸附试验(ELISA)检测尿LTE4浓度,UniCAP100变态反应检测仪检测患儿鼻咽分泌物中ECP浓度,比较各组间的差异。结果特应性组尿LTE4水平为(172.21±67.29)pg/ml,高于非特应性组的(78.21±28.78)pg/ml和正常对照组的(44.22±16.14)pg/ml,三组间差异有统计学意义(F=97.33,P<0.01);两两比较差异也均有统计学意义(P均<0.01)。RSV毛细支气管炎患儿尿LTE4与血浆IgE、鼻咽分泌物ECP水平均呈显著正相关(r=0.57、0.49,P均<0.01)。结论尿LTE4和鼻咽分泌物ECP可为RSV毛细支气管患儿的治疗和预后提供参考。

Objectives To investigate the clinical significance of the airway inflammation mediators,eosinophil cationic protein （ECP） and urinary leukotriene E4 （LTE4）,in children with respiratory syncytial virus （RSV） bronchiolitis. Methods A total of 120 inpatients with RSV bronchiolitis were classified into atopic and non-atopic groups. And 30 healthy subjects were se-lected as normal controls. Urinary LTE4 was determined by ELISA and ECP concentration in nasopharyngeal secretions （NPS） was tested by UniCAP100 allergen detector. The differences among groups were compared. Results The urinary LTE4 level in atopic group （172.21 ＆#177; 67.29 pg/ml） was elevated significantly （P＆lt;0.01） than that of non-atopic group （78.21 ＆#177; 28.78 pg/ml） and control group （44.22＆#177;16.14pg/ml）. Significance was also found between non-atopic and control groups （P＆lt;0.01）. Statistical anal-ysis indicated that urinary LTE4 positively correlated to serum IgE and ECP in children with RSV bronchiolitis （r=0.57,0.49;P＆lt;0.01）. Conclusions The level of urinary LTE4 and ECP in NPS can provide the reference for treatment and prognosis of children with RSV bronchiolitis.