支气管肺发育不良早产儿外周血清5-脂氧合酶激活蛋白、白三烯C4合成酶及半胱氨酰白三烯受体1的表达研究

Research on the expressions of peripheral serum 5-lipoxygenase activating protein,leukotriene C4 synthase and cysteinyl leukotriene receptor 1 of premature infants with bronchopulmonary dysplasia

目的:探讨新生儿呼吸窘迫综合征(neonatal respiratory distress syndrome,NRDS)及支气管肺发育不良(bronchopul-monary dysplasia,BPD)患儿血清中5-脂氧合酶激活蛋白(5-lipoxygenase activating protein,FLAP)、白三烯C4合成酶(leukotriene C4 synthase,LTC4S)及半胱氨酰白三烯受体1(cysteinyl leukotriene receptor 1,CysLTR1)水平变化的意义,旨在寻找BPD早期敏感的生物学指标。方法:收集2015年8月—2017年12月在南京医科大学第一附属医院儿科收治入院的胎龄<37周、出生体重<2 500 g的新生儿病例。待其出院后根据患儿完整住院信息将病例整理为无肺部疾病的早产儿65例(对照组),不合并BPD的NRDS早产儿60例(NRDS组),BPD早产儿49例(BPD组)。采用酶联免疫吸附试验(enzyme-linked immunosorbent assay,ELISA)检测新生儿生后3、7、14 d血清中FLAP、LTC4S、CysLTR1水平。比较3组各时间点各指标的浓度水平,采用方差分析、t检验及卡方检验等进行统计学分析。结果:生后3 d BPD组血清FLAP、CysLTR1水平均高于对照组和NRDS组(P均<0.05)。生后7 d BPD组血清FLAP、LTC4S、CysLTR1水平均高于对照组(P均<0.05),BPD组血清FLAP和CysLTR1水平分别高于NRDS组(P <0.05)。生后14 d BPD组仅血清LTC4S水平高于对照组(P <0.05)。结论:生后3 d血清PLAP、CysLTR1水平,生后7 d血清FLAP、LTC4S和CysLTR1水平,生后14 d血清LTC4S水平可作为BPD早期诊断的生物学指标。

Objective:To investigate sensitive biological indicators for early diagnosis of bronchopulmonary dysplasia(BPD)by testing the expressions of 5-lipoxygenase activating protein(FLAP),leukotriene C4 synthase(LTC4 S)and cysteinyl leukotriene receptor 1(CysLTR1)in serum of premature infants with BPD. Methods:Patients of the newborn less than 37 weeks of gestational age and less than 2 500 g of birth weight from the First Affilated Hospital of NMU were divided into 3 groups based on completed hospitalization information after discharge:premature infants without pulmonary diseases(the control group,n=65),premature infants with neonatal respiratory distress syndrome(NRDS)but without BPD(the NRDS group,n=60)and premature infants with BPD(the BPD group,n=49). Serum levels of FLAP,LTC4 S,CysLTR1 of the premature infants were tested by using enzyme - linked immunosorbent assay(ELISA)respectively at 3,7 and 14 days after birth. Statistical analysis was performed by variance analysis,t-verification and chi-square test etc. to compare the concentrations of 3 groups at different time points. Results:Serum levels of FLAP and CysLTR1 of infants with BPD at 3 days after birth were statistically significantly higher than that of NRDS and controls(P < 0.05).Serum levels of FLAP,LTC4 S and CysLTR1 of infants with BPD at 7 days after birth were significantly higher than that of controls(P <0.05). Serum levels of FLAP and CysLTR1 of infants with BPD at 7 days after birth were significantly higher than that of NRDS(P <0.05). Serum level of LTC4 S in infants with BPD at 14 days after birth was higher than that of controls(P < 0.05). Conclusion:Levels of serum FLAP and CysLTR1 of 3 days after birth,levels of FLAP,CysLTR1 and LTC4 S of 7 days after birth,and LTC4 S level of 14 days after birth may be useful biomarkers for early diagnosis of BPD.