咳嗽变异性哮喘患儿尿LTE_4水平与白三烯受体拮抗剂治疗反应的相关性  

Correlation between cough variant asthma urinary LTE4 levels and leukotriene receptor antagonist treatment response

作　　者：刘淑梅[1] 李华浚[1] 姚欢银[1] 李和权[2] 

机构地区：[1]浙江省绍兴市人民医院儿科,浙江绍兴312000 [2]浙江大学医学院附属第一医院呼吸内科,浙江杭州310003

出　　处：《中国现代医生》2014年第12期13-16,共4页China Modern Doctor

基　　金：国家自然科学基金(81170015/H1016)

摘　　要：目的研究咳嗽变异性哮喘患儿尿LTE4水平对白三烯受体拮抗剂治疗效果及免疫状态变化的影响。方法纳入符合标准的咳嗽变异性哮喘患儿136例,随机分为治疗组91例和对照组45例,在常规治疗基础上对照组采用激素吸入,治疗组采用白三烯受体拮抗剂治疗,治疗组根据尿LTE4水平分为L-LTE4组、M-LTE4组、HLTE4组,比较治疗效果及实验室指标。结果治疗组总有效率显著高于对照组(P<0.05),治疗后治疗组尿LTE4水平显著低于对照组(P<0.05)。治疗组显效率和总有效率与不同白三烯水平组均呈正相关(P<0.05)。H-LTE4组尿LTE4、外周血IgE、IL-17、TGF-β、IL-4、INF-γ水平和INF-γ/IL-4水平改变幅度最大(P<0.05)。尿LTE4与IL-17、TGF-β、INF-γ/IL-4有相关性(P<0.05)。结论白三烯受体拮抗剂治疗咳嗽变异性哮喘患儿能有效降低尿LTE4水平,疗效受到尿LTE4水平影响,并与Th1、Th2、Th7细胞功能调控有关。Objective To study urinary leukotriene receptor antagonists LTE4 levels of variant asthma and immune sta- tus change in children with cough. Methods A total of 136 cases of cough variant asthma were selected,and randomly divided into treatment group of 91 cases and control group of 45 cases. Based on the conventional treatment,45 cases were used inhaled corticosteroid, for treatment group leukotriene receptor antagonist. According to the level of urinary LTE4, treatment group were divided into into L-LTE4 group, M-LTE4 group , H-LTE4 group, compared treatment ef- fects and laboratory parameters. Results The total effective rate of the treatment group was significantly higher （P 〈 0.05）, urinary LTE4 treatment group were significantly lower than the control group （P 〈0.05）. Treatment group were efficiency and total efficiency with a different group of leukotriene levels were positively correlated （P 〈0.05）. H-LTE4 urinary LTE4, blood IgE, IL-17, TGF-β, IL-4, INF--γlevels and INF-γIL-4 levels change sharpest （P 〈0.05）. Uri- nary LTE4 and IL-17, TGF-β, INF-γ/IL-4 were correlated （P 〈0.05）. Conclusion Leukotriene receptor antagonist therapy in children with cough variant asthma could effectively reduce urinary LTE4 level, the level of efficacy by uri- nary LTE4 impact, and with the Thl, Th2, Th7 regulation of cell function.

关 键 词：咳嗽变异性哮喘 白三烯受体拮抗剂 白三烯D4 免疫应答细胞 

分 类 号：R725.6[医药卫生—儿科]