神经激肽A在哮喘患儿血浆含量变化的动态研究

目的　动态研究哮喘患儿血浆神经激肽A(NKA)含量变化规律 ,探讨NKA与小儿哮喘的关系。方法　用酶联免疫方法 ,动态测定 35例不同严重程度哮喘小儿血浆NKA在哮喘发作期及其临床症状缓解期的含量变化。结果　 (1 )小儿哮喘发作期血浆NKA含量 (2 56± 1 53)ng/L]高于自身症状缓解期 (70± 66)ng/L]及正常对照组 (38± 6)ng/L] ,差异有非常显著意义 (q分别为9 497、8 599,P均 <0 0 1 ) ;哮喘症状缓解期血浆NKA含量较正常对照组差异无显著意义 (q =1 2 4 5 ,P >0 0 5)。 (2 )哮喘小儿病情加重 ,血浆NKA含量亦随之增高 ,重度哮喘发作时血浆NKA含量 (2 96± 1 70 )ng/L]明显高于轻、中度哮喘发作时含量 (1 90± 99)ng/L] ,差异有显著意义 (q =3 77,P <0 0 5)。结论　小儿哮喘发作期血中NKA含量明显增高 ,病情愈重增高越明显 ,随哮喘症状缓解血中NKA含量下降至正常水平 ;血中NKA含量的变化与小儿哮喘的发作及缓解关系密切

Change of neurokinin A plasma level in asthmatic children

OBJECTIVE: Chronic inflammation of airway in bronchial asthma is caused by many complicated elements. Recently, a close attention has been paid to the neurogenic inflammation in airway which is mediated by sensory neuropeptides secreted by sensory nerve in the lung. Neurokinin A (NKA) is an important sensory neuropeptide leading to neurogenic inflammation in airway. Experimental studies showed that NKA has a close relation to asthma. The purpose of the present study was to investigate the changes of NKA in plasma of asthmatic children and possible relationship between sensory neuropeptides and asthma in children. METHODS: Thirty-five children with bronchial asthma were studied; 16 of the cases were < 3 yrs and 19 were >or= 3 yrs. Eighteen of the cases had severe asthma and 16 had mild asthma. None of the subjects was treated with glucocorticoid within 3 days before the study started; 15 healthy children without history of asthma or family history of asthma were enrolled as control subjects. Plasma was collected from each case during acute attack of asthma and their clinical remission of the asthmatic children. After purifying with SEP-pak C(18), NKA content was detect by enzyme-linked immunosorbent assay (ELISA) as instructed by the manufacturer of the NKA Kit (NKA unit: ng/L). RESULTS: (1) The content of plasma NKA of asthmatic children was significantly higher at the asthma attack (256 +/- 153) than that at their clinical remission stage (70 +/- 66; q = 9.497, P < 0.01) and than that of the normal control group (38 +/- 6; q = 8.599, P < 0.01); no significant difference in plasma NKA was found between the clinical remission stage and the normal control group (q = 1.245, P > 0.05). (2) There was a significant positive correlation between the asthmatic clinical state and the levels of plasma NKA; the contents of plasma NKA at the stage of acute attack in severe asthma (296 +/- 170) were significantly higher than those of the mild asthmatic children (190 +/- 99; q = 3.77, P < 0.05). CONCLUSIONS: The contents of plasma NKA were significantly higher during the asthma attack stage of children, and the higher was the level of NKA, the more severe the attack.; with asthma remission, the contents of plasma NKA decreased to normal; the contents of plasma NKA has a close relation to the asthmatic children.