血清葡萄糖-6-磷酸脱氢酶水平与儿童社区获得性肺炎的关系

Relationship betw een Serum Glucose- 6- phosphate Dehydrogenase Level and Community Acquired Pneumonia in Children

目的探讨葡萄糖-6-磷酸脱氢酶(G-6-PD)与儿童社区获得性肺炎(CAP)的关系及可能机制。方法选取确诊为CAP的患儿58例,根据病情分为普通组30例和重症组28例;随机选取同期门诊体检的健康儿童25例为对照组,检测并比较各组血清G-6-PD、还原型谷胱甘肽(GSH)、丙二醛(MDA)及谷胱甘肽过氧化物酶(GSH-Px)的水平。结果普通组及重症组血GSH水平均显著低于对照组,重症组低于普通组(均p<0.01)。普通组及重症组血MDA水平均显著高于对照组(均p<0.01),重症组高于普通组(p<0.05)。普通组血GSH-Px均显著高于对照组及重症组(均p<0.01),重症组低于对照组(p<0.05)。重症组血G6PD水平显著低于对照组及普通组(均p<0.01),普通组与对照组差异无统计学意义(p>0.05)。肺炎患儿血G6PD与GSH、GSH-Px均呈正相关(分别r=0.421、0.288,均p<0.05),与MDA呈负相关(r=-0.332,p<0.05)。结论血清G-6-PD活性与儿童CAP的严重程度密切相关,其机制可能涉及氧化应激。

Objective To study the influence of glucose - 6 - phosphate dehydrogenase （G6PD） on communi- ty acquired pneumonia （CAP） and possible mechanisms. Method A total of 58 children with CAP were classified into two groups based on disease severity, mild group （28 cases） and severe group （30 cases）, and 25 healthy children were selected as the control group. The level of reduced glutathione （GSH）, malonaldehyde （MDA）, glutathion peroxidase （ GSH - Px） and G6PD were detected and analyzed. Result Patients in mild group and severe group had significant lower GSH levels and significant higher MDA levels compared with those in the control group （ p 〈 0. 05）, while GSH levels of severe group were the lowest and MDA levels were the highest （ p 〈 0. 05 ）. Children in the mild group had significant higher GSH - Px levels than those in severe group and control group （ p 〈 0.05） , while children in the severe group had the lowest GSH - Px levels （ p 〈 0. 05 ）. Patients in the severe group had significant lower G6PD levels compared with those in the mild group and control group （ p 〈 0.01 ） , however, the difference of G6PD levels between the mild group and control group were not significant （ p = 0. 06）. GSH level and GSH - Px level in CAP children was positively correlated with GrPD activity （ r = 0. 421, 0. 288, p 〈 0. 05 ）, and MDA level was negatively correlated with G6PD activity （ r = - 0. 332, p 〈 0.05 ）. Conclusion G6PD level could be a serological markers to assist diagnosis the severity of CAP, its mechanism might be related to oxidative stress.