5岁以下喘息儿童血液中KL-6及PAI-1的变化及临床意义  

Changes and clinical significance of KL-6 and PAI-1 in the blood of children with wheeze less than 5 years old

作　　者：郭彩云 张金凤 魏楚洪 姚龙燕 孙艳娜 GUO Cai-yun;ZHANG Jin-feng;WEI Chu-hong;YAO Long-yan;SUN Yan-na(Department of Pediatrics,Women and Children′s Affiliated Hospital of Guangdong Medical University in Guangdong Province,Foshan 528300,China)

机构地区：[1]广东医科大学附属妇女儿童医院儿科,广东佛山528300

出　　处：《中国当代医药》2018年第10期95-98,共4页China Modern Medicine

基　　金：广东省佛山市科技局科研立项(2015AB002113)

摘　　要：目的探讨5岁以下喘息儿童血液中KL-6及PAI-1的变化及临床意义。方法选取2015年1月~2016年12月在我院诊断治疗的5岁以下有喘息症状的儿童198例纳入研究对象,根据API评分标准将患儿随机分为API(哮喘预测指数)阳性组(n=104),API阴性组(n=94)。两组患儿在第1~4周布地奈德混悬液及博利康尼雾化吸入,第4周后仅使用孟鲁司特钠口服治疗,评估记录各组患儿治疗前,治疗后4周,8周,12周时各时间点哮喘症状评分,并检测血液中KL-6及PAI-1的表达水平。结果 API阴性组中,各时间点KL-6、PAI-1的比较,差异无统计学意义(P>0.05);API阳性组随着治疗时间的延长KL-6及PAI-1的表达逐渐降低(P<0.05),且治疗前及治疗后4、8周KL-6及PAI-1的表达显著高于API阴性组,差异有统计学意义(P<0.05);两组治疗后12周的KL-6及PAI-1的表达水平比较,差异无统计学意义(P>0.05);两组患儿治疗前,哮喘症状评分的比较,差异无统计学意义(P>0.05);治疗后4、8、12周哮喘症状评分显著下降,与治疗前比较,差异有统计学意义(P<0.05);API阳性组治疗后4、8周哮喘症状评分显著低于API阴性组,差异有统计学意义(P<0.05),治疗后12周,两组哮喘症状评分的比较,差异无统计学意义(P>0.05)。结论 5岁以下喘息儿童血液中KL-6及PAI-1的表达呈动态变化,与哮喘症状评分有相关性。Objective To investigate the changes and clinical significance of KL-6 and Plasminogen activator inhibitor-1(PAI-1)in children with wheezing less than 5 years old.Methods A total of 198 children under 5 years of age with wheezing symptoms diagnosed and treated in our hospital from January 2015 to December 2016 were selected and randomly divided into API positive group(n=104)and API--negative group(n=94)according to API scoring criteria.Patients in the two groups were inhaled budesonide suspension and bricanyl at 1-4 weeks,and only treated with montelukast sodium orally at 4 weeks.the asthma symptom scores were recorded before treatment,4,8 and 12 weeks after treatment,and the expression levels of KL-6 and PAI-1 in blood were detected.Results There was no significant difference between KL-6 and PAI-1 in API negative group(P>0.05).The expression of KL-6 and PAI-1 in API-positive group decreased with the treatment time(P<0.05),and the expression of KL-6 and PAI-1 in API-positive group was significantly higher than that in API-negative group(P<0.05).There was no significant difference in KL-6 and PAI-1 expression between the two groups at 12 weeks after treatment(P>0.05).There was no significant difference in asthma symptom score between the two groups before treatment(P>0.05).The symptom scores of asthma decreased significantly at 4,8 and 12 weeks after treatment,the difference was statistically significant(P<0.05).The scores of asthma symptoms in API positive group were significantly lower than those in API negative group at 4 and 8 weeks after treatment,the difference was statistically significant(P<0.05);there was no significant difference in the scores of asthma symptoms between the two groups at 12 weeks after treatment(P>0.05).Conclusion The expression of KL-6 and PAI-1 in the asthmatic children less than 5 years old is in a dynamic state and associates with the symptom score of asthma.

关 键 词：喘息 肺泡Ⅱ型上皮细胞表面抗原 纤溶酶原激活物抑制剂-1 儿童 

分 类 号：R725.6[医药卫生—儿科]