白三烯B4与25-羟维生素D3在反复呼吸道感染学龄前儿童中表达的临床意义

Clinical significance of leukotriene B4 and 25-hydroxyvitamin D3 in recurrent respiratory tract infection in preschool children

目的:探讨白三烯B4(leukotriene B4,LTB4)与25-羟维生素D3在学龄前儿童反复呼吸道感染中的作用。方法:选取138例连续2年在本科室就诊的反复呼吸道感染学龄前儿童作为观察组,同时选取同期体检健康儿童84例作为对照组,对照组性别比例,年龄与观察组儿童差异无统计学意义(P>0.05)。采用ELISA检测外周血血清LTB4和25-羟维生素D3水平,并进行相关性分析。以人气道上皮细胞株H292为研究对象,采用LPS构建炎症细胞模型,分析25-羟维生素D3水平对LTB4水平的影响。结果:反复呼吸道感染患儿外周血血清25-羟维生素D3水平显著低于健康对照组,差异具有统计学意义(P<0.001),而反复呼吸道感染患儿外周血血清LTB4水平显著高于健康对照组,差异具有统计学意义(P<0.001)。上呼吸道感染平均次数和上呼吸道感染患儿外周血血清25-羟维生素D3呈负相关(r=.0.502,P=0.019);上呼吸道感染平均次数与上呼吸道感染患儿外周血血清LTB4水平呈正相关(r=0.852,P<0.001);反复性上呼吸道感染患儿血清LTB4和25-羟维生素D3水平呈负相关(r=.0.431,P=0.024)。体外细胞实验结果显示25-羟维生素D3水平能够抑制LTB4的水平。结论:学龄前儿童上呼吸道反复感染中血清25-羟维生素D3水平缺乏能够引起LTB4升高。

Objective: To investigate the role of leukotriene B4(LTB4) and 25-hydroxyvitamin D3 in recurrent respiratory infections in preschool children. Methods: One hundred and thirty-eight preschool children with recurrent respiratory tract infection who visited the undergraduate room for 2 consecutive years were selected as the observation group. Meanwhile, 84 healthy children who had physical examination at the same time were selected as the control group. There was no significant difference in gender ratio between the control group and the observation group(P>0.05). Peripheral blood serum levels of LTB4 and 25-hydroxyvitamin D3 were measured by ELISA and the correlation was analyzed. Human airway epithelial cell line H292 was studied, and an inflammatory cell model was constructed using LPS to analyze the effect of 25-hydroxyvitamin D3 level on LTB4 level. Results: Peripheral blood serum 25-hydroxyvitamin D3 level of children with recurrent respiratory tract infection was significantly lower than that of the control group(P<0.001), while peripheral blood serum LTB4 level was significantly higher than that of healthy control group(P<0.001). There was a significant negative correlation between the average number of upper respiratory tract infection and 25-hydroxyvitamin D3 in peripheral blood of children with upper respiratory tract infection(r=-0.502, P=0.019). The mean number of upper respiratory tract infection and the peripheral blood serum LTB4 level of children with upper respiratory tract infection showed a significant positive correlation(r=0.852, P<0.001). The serum levels of LTB4 and 25-hydroxyvitamin D3 showed a significant negative correlation(r=-0.431, P=0.024). Vitro cell experiments showed that 25-hydroxyl vitamin D3 levels inhibited LTB4 levels. Conclusion: The deficiency of serum 25-hydroxyvitamin D3 in the recurrent upper respiratory tract infection of preschool children can lead to increased LTB4.