哮喘患儿诱导痰液中NO_3^-/NO_2^-含量的变化及其意义  

Change of NO_3^- /NO_2^- contents in induced sputum and its clinical significance in asthmatic children

作　　者：程国强[1] 洪建国[1] 李臻[1] 李晓青[1] 王乃礼[1] 

机构地区：[1]上海市第一人民医院儿内科

出　　处：《临床儿科杂志》2001年第6期334-336,共3页Journal of Clinical Pediatrics

摘　　要：探讨儿童哮喘诱导痰液中一氧化氮(NO)代谢终产物硝酸盐/亚硝酸盐(NO_3^-/NO_2^-)含量的变化及临床意义,采用3％高渗盐水雾化吸入诱导患儿咳痰,0.1％DTT和PBS缓冲液裂解痰液,应用硝酸酶还原法和荧光酶标法分别测定诱导痰液中No_3^-/NO_2^-和嗜酸性粒细胞阳离子蛋白(ECP)含量,便携式肺功能仪测定肺通气功能。结果表明,稳定期、轻度和中、重度发作期患儿诱导痰液中NO_3^-/NO_2^-浓度较对照组显著增高,P<0.05;ECP含量较对照组显著增高,P<0.05;不同时期哮喘患儿各组间诱导痰液中NO_3^-/NO_2^-含量和ECP均有显著性差异,P<0.05。哮喘患儿诱导痰液中NO_3^-/NO_2^-和ECP含量与1秒钟用力呼气容积占预计值百分比(FEV1.0％)呈显著负相关,r=0.512,P<0.01;而NO_3^-/NO_2^-含量与痰液中ECP浓度呈显著正相关r=0.607,P<0.01。提示NO参与了儿童哮喘的发生和发展,诱导痰液中NO_2^-/NO_2^-水平可反映气道炎症的变化,可用于儿童哮喘病情监测及指导药物治疗。In order to understand the change and its clinical significance of nitric oxide (NO) terminal metabolite(NO3- / NO2-)contents in induced sputum in asthmatic children, the inhalation of 3% hypertonic saline aerosol was used to induce the sputum and, then, the sputum coughed out was degradated by adding 0. 1% dithiothreitoKDTT) solution and PBS buffer. Subsquently, NO3-/NO2- contents and eosinocyte cation protein(ECP) level were measured with nitratase reduction and EIA methods. Moreover, pulmonary ventilative functions were also assessed by portable spirometer. As a result, the sputum NO3-/NO2- contents in stable stage(19 cases),mild attack(16 cases) and moderate/severe attack(11 cases) groups showed to be significantly increased in comparison with control group(16 cases, all P<0. 05). In addition, there was also a significant difference in NO3-/NO2+ contents and ECP level among all different affected groups(all P<0. 05). On the other hand, it was also demonstrated that NO3-/NO2- and ECP contents in induced sputum in asthmatic children were found to be negatively correlated with the prediction baseline of 1 sec forced expiration volume (FEC 1.0%, r= -0. 512, P< 0. 01 )and there was evidently a positive correlation between NO3-/NO2- contents and ECP level in induced sputum(r = 0. 607,P<0. 01). Therefore , it was concluded that NO might play an important role in the onset and development of childhood asthma. The assessment of NO3-/NO2- content could reflect the changes of airway inflammation so as to be very helpful as a way of judging the severity of the disease and the effectiveness of clinical therapies in asthmatic children.

关 键 词：哮喘 痰液 一氧化氮 儿童 

分 类 号：R725.6[医药卫生—儿科]