毛细支气管炎患儿血清白细胞介素-4及尿白三烯E4水平的临床观察

目的 探讨毛细支气管炎患儿血清IL4及尿白三烯E4(LTFA)水平变化与病情分度的关系.方法 选择2006年12月至2008年12月我院小儿呼吸科住院毛细支气管炎患儿100例,按病情程度分为轻度、中重度两组,轻度组52例,中重度组48例.另选择健康体检儿50例为对照组.采用酶联免疫吸附法测定血清IL-4及尿LIFA水平.结果 毛细支气管炎患儿发病急性期血清IL-4水平为(11.34±7.56)ng/L,尿LTFA(20.3±4.75)pmol/μmol Cr;恢复期血清IL-4(6.84±5.64)ng/L及尿LTE4(3.6±1.12)pmol/μmol Cr;健康组IL-4(5.72±2.24)ng/L及尿LTFA(1.43±0.14)pmol/μmolCr.毛细支气管炎患儿发病急性期血清IL-4及尿LTE4明显增高(P<0.01).中重度组血清IL-4为(15.32±6.85)ng/L,及尿LTE4为(28.8±4.71)pmoL/μmol Cr,高于轻症组IL-4[(7.64±4.31)ng/L]及尿LTE4[(18.1±3.52)pmol/μmol Cr],两组问差异有显著性(P<0.05).恢复期IL-4为(6.84±5.64)ng/L 及尿LTFA为(3.6±1.21)pmol/μmol Cr;正常健康对照组IL-4(5.72±2.24)ng/L及尿LTE4(1.43±0.14)pmol/μmol Cr,两组间差异无显著性(P>0.01).血清IL-4与尿LTE4检测结果呈正相关,r值分别为0.628、0.564(P<0.01).结论 血清IL-4及尿LTE4水平可作为毛细支气管炎病情严重程度的指标之一,有利于指导临床诊治.     

毛细支气管炎患儿血清白细胞介素-4及尿白三烯E4水平的临床观察

目的 探讨毛细支气管炎患儿血清IL4及尿白三烯E4(LTFA)水平变化与病情分度的关系.方法 选择2006年12月至2008年12月我院小儿呼吸科住院毛细支气管炎患儿100例,按病情程度分为轻度、中重度两组,轻度组52例,中重度组48例.另选择健康体检儿50例为对照组.采用酶联免疫吸附法测定血清IL-4及尿LIFA水平.结果 毛细支气管炎患儿发病急性期血清IL-4水平为(11.34±7.56)ng/L,尿LTFA(20.3±4.75)pmol/μmol Cr;恢复期血清IL-4(6.84±5.64)ng/L及尿LTE4(3.6±1.12)pmol/μmol Cr;健康组IL-4(5.72±2.24)ng/L及尿LTFA(1.43±0.14)pmol/μmolCr.毛细支气管炎患儿发病急性期血清IL-4及尿LTE4明显增高(P<0.01).中重度组血清IL-4为(15.32±6.85)ng/L,及尿LTE4为(28.8±4.71)pmoL/μmol Cr,高于轻症组IL-4[(7.64±4.31)ng/L]及尿LTE4[(18.1±3.52)pmol/μmol Cr],两组问差异有显著性(P<0.05).恢复期IL-4为(6.84±5.64)ng/L 及尿LTFA为(3.6±1.21)pmol/μmol Cr;正常健康对照组IL-4(5.72±2.24)ng/L及尿LTE4(1.43±0.14)pmol/μmol Cr,两组间差异无显著性(P>0.01).血清IL-4与尿LTE4检测结果呈正相关,r值分别为0.628、0.564(P<0.01).结论 血清IL-4及尿LTE4水平可作为毛细支气管炎病情严重程度的指标之一,有利于指导临床诊治.     

毛细支气管炎患儿尿白三烯E4检测及其意义

目的通过检测毛细支气管炎(毛支)患儿尿白三烯E4(LTE4)水平及特应质对其的影响来探讨毛支患儿预后。方法对47例毛支患儿急性期恢复期及25例对照组进行尿LTE4测定,对急性期患儿同时检测嗜酸性粒细胞计数(EC)。结果毛支急性期尿LTE4水平(62.11±12.23)pmol/L较对照组(22.19±1.50)pmol/L、恢复期(34.86±5.75)pmol/L明显升高(P均<0.01),恢复期较对照组明显升高(P<0.01);与轻度毛支组(59.16±12.25)pmol/L比较,重度组患儿尿LTE4水平(98.04±8.04)pmol/L明显升高(P<0.01);特应质组(88.75±10.45)pmol/L毛支患儿尿LTE4水平较非特应质组(55.28±11.44)pmol/L明显升高(P<0.01);急性期毛支患儿尿LTE4水平与外周血EC计数无相关性(r=0.367,P>0.05)。结论毛支急性期尿LTE4产生增加,恢复期尿LTE4水平仍维持于高水平;重症毛支患儿尿LTE4水平明显升高,提示尿LTE4水平与病情严重程度有关;白三烯是影响特应质毛支患儿预后的重要的炎症介质;外周血EC不能很好的反映...     

呼吸道合胞病毒毛细支气管炎患儿尿白三烯E4测定的意义

目的 探讨呼吸道合胞病毒(RSV)毛细支气管炎患儿尿白三烯E4(LTE4)测定的临床意义.方法 收集30例毛细支气管炎患儿鼻咽分泌物,用直接免疫荧光法进行RSV检测.选取其中证实为RSV阳性的24例作为病例组;选取同期入院的非感染性外科疾病手术前患儿19例为对照组.二组患儿年龄分布和性别构成均无显著性差异.收集二组患儿尿液和血液,采用竞争性酶联免疫吸附试验技术检测尿LIE4水平,同时行外周血嗜酸性粒细胞计数,并进行比较;对病例组患儿尿LIE4与外周血嗜酸性粒细胞计数进行相关性分析.结果 病例组患儿尿中LTE4水平[181.0(145.8～224.7)μg/mol Cr]明显高于对照组[73.6(52.0～104.3)μg/mol Cr](t=4.77 P<0.01);病例组外周血嗜酸性粒细胞计数[(0.25±0.22)×109L-1]略低于对照组[(0.34±0.16)×109L-1],差异无统计学意义(t=1.53 P0.05).病例组患儿尿LTE4水平与外周血嗜酸性粒细胞之间无相关性(r=0.127 9 P0.05).结论 白三烯在RSV毛细支气管炎的发病机制中有不可忽视的作用,白三烯受体拮抗剂在RSV毛细支气管炎治疗上可能有一定的作用.     

急性毛细支气管炎患儿血清白细胞介素13、γ-干扰素表达的意义

目的 探讨急性毛细支气管炎患儿血清IL-13、IFN-γ表达及其临床意义.方法 用酶联免疫吸附法(ELISA)检测42例急性期毛细支气管炎患儿(其中轻症组22例,重症组20例)和20名健康婴儿血清IL-13、IFN-γ水平.采用方差分析和成组t检验,检测各组间差异.结果 1.急性毛细支气管炎患儿血清IL-13[(6.88±2.12 )ng/L]明显高于对照组[(5.48±1.28 )ng/L](P＜0.05).2.急性期毛细支气管炎患儿IFN-γ[(10.71±2.44 )ng/L]明显高于对照组[(9.20±1.54)ng/L](P＜0.05);轻症组明显高于重症和对照组(P＜0.05),而重症与对照组则无显著性差异(P＞0.05).结论 1.IL-13参与毛细支气管炎的发病过程,但其水平不能反映病情严重程度;2.IFN-γ水平在轻症毛细支气管炎组明显增高,而重症组不增高,可能与急性重症毛细支气管炎患儿IFN-γ产生受抑制有关.     

白介素-13与γ-干扰素在急性毛细支气管炎患儿血清中的表达及其临床意义

目的探讨白介素-13(IL-13)、γ-干扰素(IFN-γ)在急性期毛细支气管炎患儿血清中的表达及与病情轻重之间的相关性。方法用酶联免疫吸附(ELISA)法测定2005-02—2005-11于遵义医学院附属医院治疗的42例急性期毛细支气管炎患儿(其中轻症组22例,重症组20例)和16名健康婴儿的血清IL-13、IFN-γ的质量浓度。结果急性期毛细支气管炎患儿血清IL-13的质量浓度[(6.88±2.12)ng/L]明显高于对照组[(5.48±1.28)ng/L,P<0.01]。急性期毛细支气管炎患儿IFN-γ质量浓度[(10.71±2.44)ng/L]明显高于对照组[(9.20±1.54)ng/L,P<0.05];其中轻症组明显高于重症组和对照组(P<0.05),而重症组与对照组差异则无显著性(P>0.05)。结论急性期毛细支气管炎患儿血清IL-13质量浓度明显增高,提示IL-13参与了毛细支气管炎的发病过程,但所测质量浓度不能反映病情严重程度;IFN-γ在轻症毛细支气管炎组质量浓度明显增高,而重症组不增高,这可能与急性重症毛细支气管炎患儿IFN-γ产生受抑制有关。     

IL-13、SccAg与毛细支气管炎关系的研究

目的　探讨白细胞介素 13(IL 13)、鳞状细胞癌抗原 (SccAg)及免疫球蛋白E(IgE)与毛细支气管炎 (简称毛支 )发病机制的关系。方法　用ELISA法检测 36例毛支患儿、2 6例哮喘患儿、4 0例肺炎患儿及 33例正常儿童血清IL 13、SccAg及IgE水平 ,并对结果进行统计学处理。 结果　 (1)毛支患儿发作期血清IL 13(10 4 91± 18 0 5 )ng/L及SccAg(2 4 9± 0 38)ng/ml水平显著高于缓解期(85 15± 17 98)ng/L ,(2 30± 0 34)ng/ml及正常对照组 (77 2 7± 18 16 )ng/L ,(2 2 9± 0 34)ng/ml(P<0 0 5 ) ,而缓解期与正常对照组间无显著性差异 (P >0 0 5 )。 (2 )毛支发作期患儿血清IgE水平(370 91± 6 9 2 6 )kU/L显著高于缓解期 (189 4 6± 70 36 )kU/L(P <0 0 5 ) ,两组均显著高于正常对照组 (15 1 6 6± 70 17)kU/L(P <0 0 5 )。 (3)毛支发作期患儿血清IL 13、SccAg及IgE水平显著低于哮喘发作期 (14 7 0 0± 2 3 78)ng/L ,(3 0 1± 0 37)ng/ml,(6 5 9 5 2± 70 5 1)kU/L(P <0 0 0 1)。 (4 )毛支患儿发作期血清IL 13、SccAg及IgE水平显著高于肺炎组 (80 74± 18 0 8)ng/L ,(2 31± 0 35 )ng/ml,(15 2 87± 6 6 91)kU/L(P <0 0 5 )。 (5 )毛支患儿发作期血清IL 13水平与SccAg、IgE及SccAg与IgE水     

毛细支气管炎患儿孟鲁司特治疗前后血清和尿白三烯水平的变化

目的 探讨毛细支气管炎患儿孟鲁司特治疗前后血及尿白三烯的变化.方法 选择我院小儿内科2009年11月至2011年3月住院治疗的毛细支气管炎患儿40例作为研究对象,分为2组:(1)研究组;接受常规治疗及孟鲁司特治疗.(2)对照组:只接受常规治疗.分别于治疗前后留取患儿的血清及尿标本,检测白三烯水平.另取同期体检健康儿童20例作为正常组.结果 (1)研究组毛细支气管炎患儿急性期血清白三烯浓度(83.31±16.82) μg/L,对照组(85.62±17.91)μg/L,均显著高于正常组[(31.35±9.22) μg/L],差异有统计学意义(P＜0.05).研究组毛细支气管炎患儿应用孟鲁司特治疗后(缓解期)的血清白三烯水平为(58.69±17.95) μg/L,低于对照组(69.72±18.47)μg/L,差异有统计学意义(P＜0.05).(2)研究组毛细支气管炎患儿急性期尿白三烯浓度(353.48±121.77) μg/(L·cr),对照组(321.42±118.31) μg/(L·cr),显著高于正常组[(58.85±9.14)μg/(L·cr)],差异有统计学意义(P＜0.05).毛细支气管炎患儿应用孟鲁司特治疗后(缓解期)研究组的尿白三烯水平( 192.10±33.52) μg/(L·cr),低于对照组[(281.53±50.65) μg/(L·cr)],差异有统计学意义(P＜0.05).(3)毛细支气管炎患儿血清白三烯与尿白三烯呈正相关.结论 毛细支气管炎急性期血清及尿白三烯水平升高.孟鲁司特能降低毛细支气管炎患儿白三烯水平.     

婴幼儿呼吸道疾病血清细胞因子的检测及临床意义

应用ELISA法,检测0.5岁～1岁组328例肺炎和364例毛细支气管炎(毛支)患儿患病极期IFN-α、IL-2，IL-4的含量。结果表明肺炎组血清IFN-α、IL-2和IL-4含量分别为501．2ng/L±97．6ng/L、316.8ng/L±86．2ng/L和18．2ng/L±11．4ng/L。其IFN-α，IL-2含量均高于同龄对照组．IL-4含量低于同龄对照组，t值分别为15.8、9.80、8.90，P<O．001。毛支组血清IFN-α,IL-2和IL-4含量分别为238．0ng/L±102．4ng/L、89．6ng/L±29.8ng/L和84．6ng/L±37．2ng/L,其IFN-α,IL-2的含量低于同龄对照组,IL-4的含量高于同龄对照组．T值分别为6．70、13．5和17．6．P<0.001。肺炎，毛支患儿血清中IFN-α与IL-4亦呈负相关(r1＝-0.54、r2＝-0．68，P<0．01)。说明，IFN-α与IL-4这对拮抗因子在两种疾病中呈异常比值关系，可作为判断感染或过敏的一项指标，为临床提供治疗依据。     

血清白细胞介素-17、白三烯B4及IgE水平在哮喘患儿中的表达及意义

目的 探讨血清白细胞介素-17(IL-17)、白三烯B4(LTB4)及总IgE水平在支气管哮喘发病中的作用及其关系.方法 研究组选择哮喘急性发作患儿60例(其中轻度组29例,中重度组31例),对照组选择健康儿童24例.应用酶联免疫吸附法检测各组儿童血清IL-17、LTB4水平,荧光酶联免疫法检测血清总IgE水平,哮喘患儿进行肺功能检测.全自动血液分析仪进行外周血中性粒细胞计数.结果 (1)哮喘轻度组、中重度组与对照组血清IL-17水平分别为(1.15±0.10)μg/L、(2.80±2.30)μg/L、(0.83±0.10)μg/L;LTB4水平分别为(2.22±1.01)μg/L、(8.79±9.36)μg/L、(1.94±1.13)μg/L;IgE 水平分别为(123.70±86.94)μg/L、(322.27±332.28)μg/L、(24.27±7.64)μg/L,组间比较差异均有统计学意义(P＜0.001);(2)哮喘轻度组、中重度组与对照组血清中性粒细胞百分比分别为(55.06±11.15)％、(64.44±11.87)％、(47.96±13.52)％,淋巴细胞百分比分别为(42.20±11.04)％、(33.93±10.02)％、(49.65±13.02)％,组间比较差异有统计学意义(P＜0.05);(3)哮喘患儿血清IL-17与IgE水平呈正相关(P=0.004),哮喘患儿血清LTB4与IgE水平呈正相关(P=0.011),哮喘患儿血清IL-17与LTB4水平呈正相关(P=0.000);(4)哮喘患儿血清IL-17、LTB4水平与FEV1(P=0.000)及PEF(P=0.000)均呈负相关,与中性粒细胞百分比呈正相关(P=0.000).结论 IL-17、LTB4及IgE在哮喘的急性发作及加重中起着重要作用,在哮喘发病中彼此相互影响,共同参与哮喘的病理生理改变.     

Cytomegalovirus-associated stage 4S neuroblastoma relapsed stage 4

Neuroblastoma is one of the most frequent solid tumors in childhood, rarely recurrent after five years from diagnosis. Cytomegalovirus (CMV), a major pathogen causing congenital birth defects and severe opportunistic diseases, has been shown to have teratogenic, immunodepressive and oncogenic properties. The case of a girl with stage 45 neuroblastoma diagnosed at three months and relapsed as stage 4 five years later is reported. In both circumstances, active CMV infection was revealed by positive CMV-specific IgM and IgA antibodies, CMV-DNAemia and CMV culture. At three months, the patient presented with subcutaneous nodules, hepatosplenomegaly and increased aminotransferase levels, and the opsoclonus-myoclonus syndrome. Mental retardation developed later on. At 5 years, relapsed neuroblastoma was preceded by a mononucleosis-like syndrome concomitant with active CMV infection and decreased levels of immune cells and natural killer activity. Clinical, virologic, and immunologic findings suggest an immune-mediated pathogenic role for CMV in this tumor. © 1995 Wi1ey-Liss Inc.     

Effects of leukotrienes C4, D4, and E4 on cerebral arteries of newborn pigs

We examined effects of topical application of leukotrienes (LT) C4, D4, and E4 on cerebral arteries of newborn pigs in vivo. Diameters of pial arteries were measured using a cranial window method during application of artificial cerebrospinal fluid without drug, and cerebrospinal fluid containing LT C4, D4, and E4 (1, 10, 100, 1000, and 5000 ng/ml). Control diameters ranged from 51-345 micron. All three LT constricted pial arteries in a dose-dependent manner, with a threshold for detectable response at 10 ng/ml (7 +/- 3% for LTD4). The magnitude of constrictor response at the highest dose was 23 +/- 3% for LTC4, 17 +/- 2% for LTD4, and 17 +/- 3% for LTE4. The specific receptor antagonist FPL 55712 blocked the constrictor response to LT. We conclude that LT are potent constrictors of cerebral arteries in newborn pigs.     

Blood levels of leukotrienes (LTC4, D4, E4, B4) and synthesis of leukotriene B4 by peripheral leukocytes in children with acute A and B hepatitis

Leukotrienes (LTs) are cell-membrane derived lipid inflammatory mediators, synthesized and eliminated by the liver. LTs have effects on liver cells in some pathological conditions. In this study, we measured plasma endogenous and liberated leukotriene (LT) concentration in peripheral blood leukocytes stimulated in vitro by the calcium ionophore (CaA23187) and platelet-activating factor (PAF). Production of LTs was measured in type A (n=37) and type B (n=10) acute hepatitis patients and control subjects (n=10). LTs levels were measured by high performance liquid chromatography (HPLC) and radioimmunoassay (RIA). The concentration of LTB4 measured in plasma and stimulated peripheral blood leukocyte supernatants of children with hepatitis A infection was found to be statistically elevated and in positive correlation with serum alanine aminotransferase (ALT) levels. In plasma samples of hepatitis B patients, LTC4 and LTE4 were measured in significantly elevated concentrations. These results suggest that LTB4 may be a critical mediator of hepatitis A virus-induced hepatocellular injury.     

Increased gastric juice leukotriene B4, C4 and E4 concentrations in children with Helicobacter pylori colonization

During recent years, the role of inflammatory lipid mediators in the pathophysiology of Helicobacter pylori (H. pylori) infections has been investigated in several studies. The concentrations of leukotrienes (LTs) in gastric juice from H. pylori positive (n = 13) and negative (n = 18) children with recurrent abdominal pain were studies in order to determine whether these lipid inflammatory mediators are involved in local and systemic biological actions. Gastric juice samples and biopsy specimens of mucosa were obtained endoscopically from 31 patients with recurrent abdominal pain for assessment of LTs and histopathological examination. In this study, all children with recurrent abdominal pain were investigated by rapid urease test and histological assessment for H. pylori colonization. Leukotriene levels were measured by high performance liquid chromatography (HPLC) and radioimmunoassay (RIA) in gastric juice samples. Gastric juice LTB4, LTC4, and LT4 levels were significantly higher in patients with H. pylori colonization than in children without H. pylori colonization. These results indicate that increased gastric content of proinflammatory mediators (LTB4, LTC4, and LT4) may be related to the pathogenesis of H. pylori-associated gastritis.