咳嗽变异性哮喘患儿尿白三烯E_4测定的意义

目的探讨咳嗽变异性哮喘(CVA)患儿尿白三烯E4(LTE4)测定的临床意义。方法收集咳嗽变异性哮喘46例作为病例组,并随机分成孟鲁司特治疗组(n=24)和常规治疗组(n=22);选取同期门诊健康体检儿童20例为对照组。检测两组急性发作期和缓解期尿LTE4水平和外周血嗜酸性粒细胞计数,并进行比较;对病例组患儿尿LTE4与外周血嗜酸性粒细胞计数进行相关性分析。结果孟鲁司特组、常规治疗组缓解期较急性期尿LTE4明显降低,P<0.01;缓解期孟鲁司特治疗组儿童尿LTE4水平显著低于常规治疗组,差异有统计学意义(P<0.01);两组与健康对照组比较,差异均有统计学意义;且孟鲁司特组、常规治疗组尿LTE4下降值有显著性差异(P<0.05)。急性期咳嗽变异哮喘儿童尿LTE4水平与外周血嗜酸性粒细胞计数无相关性(P>0.05)。结论白三烯在咳嗽变异性哮喘的发病机制中有重要作用,白三烯受体拮抗剂在咳嗽变异性哮喘治疗上的作用是显著的。测定CVA患儿尿LTE4水平可以为CVA的临床诊断和治疗监测提供依据。

Significance of Urinary Leukotriene E4 Detection in Children with Cough Variant Asthma

Objective To explore the clinical significance of urinary leukotriene E4 （LTE4） detection in children with cough variant asthma. Methods Fouty-six children with cough variant asthma were randomly divided into montelukast （leukotriene receptor antagonist） treatment （n=24） and conventional treatment groups （n=22） . LTE4 levels were measured and the peripheral eosinophils count was assessed at the acute and the convalescence phases. Twenty healthy children were used as the control group. Results The levels of urinary LTE4 of acute phases were significantly higher than that of convalescence phases both montelukast and conventional treatment groups （P〈0.01） . Urinary LTE4 levels in CVA children at the acute and the convalescence phases were significantly higher than those in the control group （P〈0.01） . The levels of urinary LTE4 in montelukast group were significantly higher than that of conventional treatment group in the convalescence phases （P〈0.01） . More significantly decreased urinary LTE4 levels were noted in the montelukast treatment group than the conventional treatment group （P〈0.05） . There was no correlation between urinary LTE4 and the peripheral eosinophil count （P〉0.05） . Conclusions Leukotriene receptor antagonistmay play an important role in the pathogenesis of CVA. The curative effect of leukotriene receptor antagonist is significantly in CVA children. Urinary LTE4 is a useful marker for the diagnosis of CVA and can be as a predictor of CVA control and marker of susceptibility to treatment with leukotriene receptor antagonists.