白三烯B4与儿童腺样体肥大的关系研究

Study on the relationship between leukotriene B4 and pediatric adenoidal hypertrophy

目的:检测腺样体肥大患儿腺样体组织和外周血中白三烯B4(LTB4)的浓度,探讨LTB4在腺样体肥大中的意义。方法:将准备接受腺样体切除术的实验组腺样体肥大患儿分为反复呼吸道感染组(A组),过敏性鼻炎组(B组)和阻塞性睡眠呼吸暂停组(C组),每组选取30例患儿。术前抽取外周血,术后留取腺样体组织标本。同时选取10例反复感染性扁桃体炎儿童的扁桃体组织作为组织标本对照组(D组)和10例正常健康体检儿童的外周血作为外周血标本对照组(E组)。应用酶联免疫吸附检测法(ELASA)分别检测各组患儿组织和血清的LTB4的浓度,统计分析各组之间的差异。结果:1实验组织样本组A、B、C的LTB4与D组比较,外周血样本组A、B、C的LTB4与对照组E组比较,组织和外周血LTB4浓度明显高于对照组,差异有统计学意义(P<0.01);2实验组A、B、C的组织LTB4浓度高于外周血(P<0.05);实验组各A、B、C之间LTB4的组织学和外周血浓度组间两两比较,差异无统计学意义(P>0.05);3实验组90例患儿再按严重程度区分,分为中度35例和重度55例,外周血和组织中LTB4浓度与腺样体肥大程度呈正相关(P<0.001)。结论:LTB4是参与腺样体肥大的重要的炎症因子之一,其升高水平与腺样体肥大的程度相关。

Objective： To detect the levels of leukotriene B4 （LTB4） in adenoid tissue and peripheral blood of children with adenoidal hypertrophy, explore the significance of LTB4 in pediatric adenoidal hypertrophy. Methods： The children with adenoidal hypertrophy in experimental group scheduled for adenoidectomy were divided into group A （recurrent respiratory tract infection）, group B （allergic rhinitis）, and group C （obstructive sleep apnea）, 30 children in each group. Peripheral blood specimens were obtained before ade- noidectomy, adenoid tissue specimens were obtained after adenoidectomy. Tonsillar tissue specimens of 10 children with recurrent infective tonsillitis were selected as group D, peripheral blood specimens of 10 normal children after healthy physical examination were selected as group E. ELASA was used to detect LTB4 levels in tissue and serum specimens of different groups, the differences were analyzed. Results： The levels of LTB4 in tissue specimens of group A, group B, and group C were statistically significantly higher than that of group D （P〈 0. 01 ） ; the levels of LTB4 in peripheral blood specimens of group A, group B, and group C were statistically significantly higher than that of group E （P〈0.01） . In group A, group B, and group C, LTB4 levels in tissue specimens were statistically significantly higher than that in peripheral blood （P〈0. 05）. There Was no statistically significant difference in LTB4 level between tissue specimens and peripheral blood specimens in group A, group B, and group C （ P〉0. 05 ） . Ninety patients in experimental group were divided into moderate group （ 35 children） and severe group （55 children） according to the severity, LTB4 levels in peripheral blood and tissue specimens were positively correlated with the severity of adenoidal hypertrophy （P〈 0. 001 ） . Conclusion： LTB4 is one of the important inflammatory factors contributing to adenoid hypertrophy, the increasing level of LTB4 is correlated with the severity of adenoid hypertrophy.