支气管哮喘儿童尿白三烯E4检测的临床意义

Urinary leukotrience E4 Level in children with asthma

摘要:

目的:半胱氨酰白三烯（CysLTs）是参与哮喘气道炎症与重塑的重要介质，通过检测尿白三烯E4（LTE4）可以反映人体CysLTs的水平。该研究旨在探讨尿LTE4测定在儿童支气管哮喘中的临床意义。方法:将60例哮喘急性发作儿童随机分成孟鲁司特治疗组和常规治疗组，每组各30例。采用竞争性酶联免疫吸附试验技术（ELISA）检测急性期和缓解期患儿尿LTE4 水平，并测定气道阻力值(Rint)。同时选择20例健康儿童作为对照组。结果:哮喘儿童急性期、缓解期尿LTE4水平均明显高于对照组儿童，差异有显著性(均P<0.01)。缓解期哮喘儿童尿LTE4 较急性期下降，差异有显著性(P<0.01)，且孟鲁司特治疗组儿童尿LTE4下降值明显高于常规治疗组，差异有显著性（P<0.01）。急性期哮喘儿童尿LTE4水平与Rint无相关性(P>0.05)。结论:急性期哮喘儿童尿LTE4水平明显升高；检测哮喘儿童尿中LTE4水平可以为哮喘的临床诊断和治疗监测提供依据。［中国当代儿科杂志，2009，11（11）：909-912］

Abstract:

OBJECTIVE: Cysteinyl leukotriene (CysLTs) plays an important role in airway inflammation and remodeling in asthma. Measurement of urinary leukotriene E4 (LTE4) is a sensitive and noninvasive method of assaying total body CysLTs level. This study aimed to evaluate the clinical significance of urinary leukotriene E4 (LTE4) in childhood asthma. METHODS: Sixty children with acute asthma were randomly divided into montelukast (leukotriene receptor antagonist) treatment and conventional treatment groups (n=30 each). Urinary LTE4 levels were measured using ELISA and the airway resistance Rint was assessed by the lung function instrument at the acute and the convalescence phases. Twenty healthy children were used as the control group. RESULTS: Urinary LTE4 levels in asthmatic children at the acute and the convalescence phases were significantly higher than those in the control group (P<0.01). The urinary LTE4 levels at the convalescence phase were significantly reduced compared with those at the acute phase in asthmatic children (P<0.01). More significantly decreased urinary LTE4 levels were noted in the montelukast treatment group than the conventional treatment group at the convalescence phase (P<0.01). In the acute phase, there was no correlation between urinary LTE4 level and Rint in asthmatic children. CONCLUSIONS: Urinary LTE4 level is significantly increased in children with acute asthma. Urinary LTE4 is a useful marker for the diagnosis of asthma and can be as a predictor of asthma control and marker of susceptibility to treatment with leukotriene receptor antagonists.［Chin J Contemp Pediatr, 2009, 11 (11):909-912］