呼吸道合胞病毒毛细支气管炎患儿血清糖皮质激素受体水平变化及意义

Clinical Significance and Changes of Glucocorticoid Receptor in Serum with Respiratory Syncytial Virus Bronchiolitis

目的通过检测RSV毛细支气管炎患儿血清GRα、GRβ水平,探讨GR亚型表达对RSV毛细支气管炎严重程度的影响。方法采用ELISA法测定和比较不同程度RSV毛细支气管炎组(轻度42例,重度24例)和对照组(48例)患儿血清中GRα、GRβ水平变化,同时对RSV毛细支气管炎严重程度与GRα/GRβ比值之间进行相关性分析。结果与对照组比较,轻度和重度RSV毛细支气管炎组血清GRα、GRβ水平均显著升高(P <0. 01);与轻度组比较,重度RSV毛细支气管炎组血清GRα、GRβ水平显著升高(P <0. 01); GRα/GRβ比值在重度组显著低于轻度组和对照组(P均<0. 01),后两组比较差异无统计学意义。通过相关分析发现,RSV毛细支气管炎严重程度与GRα/GRβ比值之间呈显著负相关(r=-0. 588,t=5. 816,P <0. 05)。结论 RSV毛细支气管炎患儿表现为血清GRα、GRβ水平的高表达,在重度患儿中表现更为明显; GRα/GRβ比值则在重度RSV毛细支气管炎中明显降低,而且RSV毛细支气管炎严重程度与GRα/GRβ比值之间呈显著负相关。

Objective To explore the role of GR expression on the severity of RSV of bronchiolitiss. Methods The serum of GRα、GRβ levels were measured and compared using ELISA in 66 cases of RSV bronchiolitis （42 mild cases, 24 severe cases） and 48 cases of controls who were without recent infection waiting for surgery. At the same time, the correlation between the severity of RSV bronchiolitis and the ratio of GRα/GRβ was analyzed. Results The serum of GRα、GRβ levels in mild and severe RSV bronchiolitis were significantly higher than the control group （ P 〈0.01）, while the severe group were significantly higher than the mild group（ P 〈0.01）,the ratio of GRα/GRβ in severe group was significantly lower than the mild group and control group（ P 〈0.01）, and there was no significant difference between the latter two groups （ P〉 0.05）. There is clearly a negative correlation between the severity of RSV bronchiolitis and the ratio of GRα/GRβ （ r =-0.588, t =5.816, P 〈0.05）. Conclusion The levels of serum GRα,GRβ were increased in RSV bronchiolitis,especially in severe group. The ratio of GRα/GRβ was decreased in the severe group, while a negative correlation between the severity of RSV bronchiolitis and the ratio of GRα/GRβ.