成人哮喘慢性持续期肺功能与白三烯水平相关性研究

Association between pulmonary function and leukotriene ir adult chronic persistent asthmatic patients

目的:观察机体白三烯水平与成人支气管哮喘慢性持续期肺功能指标第1秒用力呼气容积(forced expiratory volume in one second,FEV1)/用力肺活量(forced vital capacity,FVC)比值及FEV1值的相关性,探讨白三烯水平对慢性持续期哮喘患者肺功能的影响。方法:募集成人慢性持续期哮喘患者96例,所有患者均按常规吸入福莫特罗/布地奈德进行基础治疗。治疗前及治疗后8周用ELISA检测尿白三烯E4(leukotriene E4,LTE4)浓度,用肺功能仪检测患者FVC值及FEV1值。同时募集健康对照者40例,检测尿LTE4水平。比较健康对照者与不同病情严重程度哮喘患者尿LTE4水平的差异,以及FEV1/FVC及FEV1值与尿LTE4水平的相关关系。结果:1)轻度持续、中度持续及重度持续期哮喘患者尿LTE4浓度均高于健康对照组(P<0.05),且随着病情严重度增加尿LTE4浓度也升高。2)初始治疗前中度持续期患者FEV1/FVC及FEV1值与尿LTE4浓度均呈负相关(P<0.05)。结论:中度持续的哮喘患者肺功能与体内白三烯水平关系更为密切,中、重度持续的哮喘患者初始治疗时加用白三烯受体拮抗剂可能会更快改善肺功能。

Objective： To investigate the effect of leukotriene levels on the pulmonary function of patients with chronic persistent asthma, and to observe the correlation between concentration of leukotriene E4 （LTE4） in urine and the patients forced expiratory volume in the ifrst second （FEV1）/forced vital capacity （FVC） and FEV1 value. Methods： Ninety-six patients of asthma were studied and classified into three groups based on the severity of expiratory airlfow limitation： 1） mild persistent asthmatic group （FEV1 〉80% predicted） included 40 patients; 2） moderate persistent asthmatic group （FEV1 of 60% to 80% predicted） included 48 patients; and 3） severe persistent asthmatic group （FEV1 〈60% predicted） included 8 patients. All patients were used budesonide and 〈br〉 formoterol fumarate powder for inhalation. Before treatment and atfer treatment for 8 weeks, the concentration of urinary LTE4 were detected by ELISA, FEV1/FVC and FEV1 measured by pulmonary function instrument. At the same time, 40 cases of healthy controls were collected to detect the urinary LTE4.Results： 1） urinary LTE4 concentrations in mild, moderate and severe persistent patients were higher than those in healthy control group （P〈0.05）, and with the severity of the disease, the urinary LTE4 concentration was increased; 2） FEV1/FVC and FEV1 values were negatively correlated （P〈0.05） in patients with moderate persistent asthma before budesonide and formoterol fumarate powder for inhalation treatment.Conclusion：The correlation between pulmonary function and leukotriene levels in moderate persistent asthmatic patients was more closely, moderate persistent and severe persistent asthmatic patients would beneift from administrated leukotriene receptor antagonist agents.