血脂与儿童期哮喘的相关性

Association of blood lipids with childhood asthma

摘要:

目的 探讨血脂与哮喘的发生、临床分期、过敏情况及肺功能的关系。方法 选取2016年10月至2017年3月就诊的56例哮喘患儿为哮喘组，46例行健康体检儿童为健康对照组。根据哮喘患儿的临床表现分为急性发作期组（n=24）和慢性持续期组（n=32）。根据皮肤点刺试验和血清IgE测定结果将哮喘患儿分为非过敏性哮喘组（n=16）和过敏性哮喘组（n=38），2例未测定。检测哮喘组和健康对照组儿童的空腹血脂水平，并对哮喘患儿进行肺功能检测。结果 哮喘组与健康对照组儿童各项血脂水平比较差异均无统计学差异（P > 0.05）；与慢性持续期组及健康对照组相比，急性发作期组患儿血清高密度脂蛋白（HDL）、总胆固醇（TC）水平降低（P < 0.05）；与非过敏性哮喘组相比，过敏性哮喘组患儿血清HDL水平降低（P < 0.05）；在6~13岁年龄组哮喘患儿中，用力肺活量、呼气峰流速、用力呼气50%流量的实测值占预计值的百分比均与HDL有线性回归关系，且均与HDL呈正相关（P < 0.05）；一秒用力呼气容积、最大呼气中期流速与HDL、LDL有线性回归关系，且均与HDL、LDL呈正相关（P < 0.05）。结论 血脂与儿童期哮喘的临床分期、过敏情况及肺功能均有关，提示血脂可能参与了儿童哮喘发病机制的多个环节。

Abstract:

Objective To study the association of blood lipids with the development, clinical stage, allergic condition, and pulmonary function of asthma. Methods A total of 56 children with asthma who attended the hospital between October 2016 and March 2017 were enrolled as the asthma group, and 46 children who underwent physical examination as the healthy control group. According to the clinical manifestations, the children with asthma were divided into acute exacerbation group (n=24) and chronic persistent group (n=32). According to the results of skin prick test (SPT) and serum IgE measurement, the children with asthma were divided into non-allergic asthma group (n=16) and allergic asthma group (n=38). Fasting blood lipid levels were measured in both asthma and control groups. Pulmonary function tests were performed for asthmatic children. Results There were no significant differences in blood lipid levels between the asthma and control groups (P > 0.05). The acute exacerbation group had significantly lower serum levels of high-density lipoprotein (HDL) and total cholesterol compared with the control group and the chronic persistent group (P < 0.05). The allergic asthma group had a significantly lower serum HDL level than the non-allergic asthma group (P < 0.05). In asthmatic children aged 6-13 years, the ratios of the measured values to the predicted values for forced vital capacity, peak expiratory flow, and maximal expiratory flow at 50% of vital capacity had a linear regression relationship with HDL and were positively correlated with HDL (P < 0.05). Forced expiratory volume in one second and maximal mid-expiratory flow had a linear regression relationship with both HDL and LDL and were positively correlated with them (P < 0.05). Conclusions Blood lipids are associated with the clinical stage, allergic condition, and lung function of childhood asthma. This indicates that blood lipids may be involved in several aspects of the pathogenesis of childhood asthma.