血清内皮功能标记物甲基化精氨酸与婴幼儿喘息性疾病的相关性研究

The correlation study of serum asymmetric dimethylarginines,an endothelial function biomarker,with pediatric wheezing diseases

目的探讨血清内皮功能标记物不对称二甲基精氨酸(ADMA)和对称二甲基精氨酸(SDMA)在婴幼儿喘息类疾病中的变化及其对哮喘的预测作用。方法收集74例婴幼儿血清,分为四组:毛细支气管炎组(简称毛支组)(18例)、哮喘组(16例)、肺炎组(22例)和对照组(18例),比较各组血清中L-精氨酸、不对称二甲基精氨酸(ADMA)和对称二甲基精氨酸(SDMA)的含量;对毛细支气管炎和哮喘的婴幼儿进行为期1年的随访。结果哮喘组ADMA水平显著高于肺炎组和对照组,其他各组间ADMA均无显著差别;肺炎组、毛细支气管炎组和哮喘组血清中SDMA水平对比对照组均有显著增加(P<0.001);各组血清L-精氨酸的含量均无显著差别;精氨酸甲基化指数(AMI)在哮喘组显著高于对照组(P<0.05)。随访1年内出现至少1次反复咳嗽或喘息的哮喘和毛细支气管炎的婴幼儿急性期血清ADMA水平显著高于没有出现反复咳嗽或喘息的婴幼儿(P<0.05),ROC分析AUC=0.829(0.649~1.008),P<0.05。结论(1)婴幼儿哮喘与精氨酸甲基化率增加有关,ADMA是潜在的生物学标记物;(2)SDMA参与婴幼儿喘息类疾病和肺炎的共同病理进程。

Objective To investigate the changes of serum endothelial functional markers asymmetric dimethylarginine(ADMA)and symmetric dimethylarginine(SDMA)in the condition of pediatric wheezing diseases and their capacity in the prognosis prediction of asthma.Methods 74 serum samples including 18 samples from capillary bronchitis(CB)patients,16 from asthma,22 from pneumonia,and 18 from normal controls were collected from infants and young children.The concentrations of L-arginine,ADMA,and SDMA in the samples were determined and compared.A one-year follow-up was conducted on the CB and asthma patients.Results The concentrations of ADMA in the asthma group were significantly higher than that in pneumonia and normal group(P<0.05),while there was no significant difference in ADMA among other groups.The SDMA levels in the pneumonia group,CB group,and asthma group were significantly higher than those in the controls(P<0.01).There was no significant difference in serum L-arginine content among all groups.The arginine methylation index(AMI)in the asthma group was significantly higher than that in the control group(P<0.05).The level of serum ADMA in infants with asthma and bronchiolitis who had at least one recurrent cough or wheezing during 1 year of follow-up was significantly higher than that in infants without recurrent cough or wheezing.ROC analysis AUC=0.829(0.649-1.008),P<0.05.Conclusions(1)Infant asthma is associated with increased arginine methylation rate,and ADMA is a potential biological marker;(2)SDMA is involved in the common pathological process of infant wheezing disease and pneumonia.