婴幼儿喘息性疾病血红素加氧酶-1与一氧化碳的临床意义

Implication of blood heme oxygenase-1 and carboxyhemoglobin levels in infantile wheezing diseases

目的探讨血红素加氧酶—1(HO—1)与一氧化碳(CO)在喘息性疾病婴幼儿血清中含量变化及其临床意义。方法收集1 12例4岁以下喘息息儿,根据《儿童社区获得性肺炎管理指南(2013修订)》分为重症组(存在低氧血症)4g例和轻症组(无低氧血症)63例;选择同期同年龄段急性支气管炎患儿58例为对照组。采用双抗体夹心ELISA技术测定患儿血清HO—1含量,应用双波长分光光度法测定患儿血中碳氧血红蛋白(COHb)含量,进行组间比较分析。结果急性期(入院时)3组间HO—1和COHb含量差异均有统计学意义(均P<0.01),两两比较,仅重症组(2 577.01±879.47)ng/L、(3.84±0.87)%明显高于轻症组(1 382.90±731.80)ng/L、(1.17±0.60)%和对照组(1 113.73±606.25)ng/L、(1.01±0.54)%(均P<0.01)。重症组HO—1和COHb含量,均为急性期高于恢复期(均P<0.01)。急性期重症组HO—1与COHb含量呈正相关(r=0.340,P<0.05)。结论 HO—1和CO可能参与婴幼儿喘息性疾病发展过程,急性重症期两者呈正相关,具有诊断疾病、判断严重程度与预后等临床意义。

Objective To investigate the implication of blood heine oxygenase-1 （HO-1） and carboxyhemoglobin （COHb） levels in infantile wheezing diseases. Methods One hundred and twelve infants aged 〈3 years with wheezing diseases and 58 infants with acute bronchitis （control group） were enrolled in this study. According to the guidelines for management of childhood community acquired pneumonia （2013 version）, the patients were classified as severe wheezing group （n=49） and mild wheezing group （n=63）. The serum HO-1 were measured by ELISA, the blood COHb levels were measured by dual-wavelength spectrophotometry. Results The HO-1 activities and COHb levels in acute stage of severe wheezing group were markedly higher than those of the mild wheezing group and the control group （P〈0.01）, there were no significant difference in HO-1 and COHb levels between mild wheezing group and control group. Compared with the convalescent stage, the HO-1 activities and COHb levels were significantly higher in acute stage of severe wheezing group （P〈0.01）, and there were no statistical difference in HO-1 activities and COHb levels between acute stage and convalescent stage in mild wheezing group and control group （P〈 0.05）. The HO-1 and COHb were correlated in acute stage of severe wheezing group （r=0.340, P〈0.05）. Conclusion With the wheezing disease progressing, the blood HO-1 and COHb increase, indicating that these two parameters may be used for judgment of disease severity.