毛细支气管炎患儿血内皮素和一氧化氮的监测

Monitoring plasma endothelin and serum nitric oxide in children with bronchiolitis

目的 探讨血内皮素 (ET)和一氧化氮 (NO)在毛细支气管炎 (毛支 )中的变化及相互关系。 方法 用放射免疫分析法和分光光度比色法分别检测毛支患儿血ET和NO ,并与正常儿童进行比较 ;检测重症毛支患儿急性期动脉血氧分压 (PaO2 )和二氧化碳分压 (PaCO2 ) ,并与血ET和NO进行直线相关分析。 结果 血浆ET在毛支轻症组和毛支重症组 ,急性期均明显高于正常组 (分别 q =14 6 5 4、12 370 ,P均 <0 0 1) ,缓解期均下降 ,与正常组比较无显著差别 (分别 q =0 114、0 6 81,P均 >0 0 5 ) ;毛支轻症组和毛支重症组自身对照比较 ,急性期均高于缓解期 (分别 q =16 2 37、11 413 ,P均 <0 0 1)。与血浆ET一样 ,血清NO在毛支轻症组和毛支重症组 ,急性期均显著高于正常组 (分别q =6 95 5、3 338,P分别 <0 0 1和 <0 0 5 ) ,缓解期则下降 ,与对照组无差别 (分别 q =0 771、0 0 89,P均 >0 0 5 ) ;毛支轻症组和毛支重症组不同阶段NO值比较 ,急性期高于缓解期 (分别 q =8 6 30、2 984,P分别 <0 0 1和 <0 0 5 ) ;两组急性期相比 ,差异无显著性 ( q =2 0 83,P >0 0 5 ) ,但重症组低于轻症组。两组急性期血浆ET和血清NO呈明显正相关 (r =0 6 14 ,P <0 0 1)。血浆ET与PaO2 呈显著负相关 (r =-0 793 ,P <0

Objective To study the changes and relation of plasma endothelin(P ET)and serum nitric oxide(S NO)in children with bronchiolitis.Methods The P ET and S NO of children with bronchiolitis were determined by radioimmunoassay and colorimetry respectively and compared with normal children;The pressure of arterial O 2(P aO 2)and the pressure of arterial CO 2(PaCO 2)of the severe patients in acute period were measured and correlatively analyzed with their P ET and S NO.Results The P ET of children with bronchiolitis(both mild and severe group)was significantly higher than normal group in acute period ( q =14 654,12 370,respectively, P <0 01),and all decreased to normal level in remission period.The P ET of each group in acute period was higher than that in remission period( q =16 237,11 413 respectively, P <0 01).The P ET of severe group was higher than that of mild one,but not significantly.The S NO of two groups both mild and severe group)were significantly higher than normal group in acute period,( q =6 955,3 338, P <0 01 and P <0 05,respectively),and turned to normal in remission period.The S NO of each group in acute period was higher than that in remission period( q =8 630,2 984,and P <0 01,and P< 0 05,respectively)The S NO of severe group was lower than mild group in acute period,but the difference was not significant.The P ET of two groups was significantly positive related to their S NO in acute period( r =0 614, P <0 05).The P ET of severe group was negatively related to PaO 2( r =-0 793, P <0 05),positively related to their PaCO 2( r=0 701,P <0 05) in acute period.No correlation between the S NO and P aO 2 or P aCO 2 was found.Conclusion It was showed that the P ET and S NO were all elevated in bronchioloitis.The elevated ET in blood may be related to low O 2.The high CO 2 was an important cause of stimulating ET elevationg.ET and NO may play an important role in the pathogenesis of bronchiolitis.thus,it is speculated that besides improving airway ventilation and correcting low O 2,the administration of ET antagonists and NO synthase inhibitors may set up a new pathway in therapy for children with bronchiolitis.