毛细支气管炎患儿血清肺表面活性蛋白A和D的检测及临床意义

目的：探讨血清肺表面活性蛋白A（SP-A）和D（SP-D）在不同程度毛细支气管炎患儿中的变化及其临床意义。方法：将70例毛细支气管炎患儿依据临床症状分为毛细支气管炎急性期组（42例）和恢复期组（28例），另选取26例同期因非感染性疾病住院的小儿外科术前患儿为对照组；同时依据症状严重程度将急性期毛细支气管炎患儿分为重症组（12例）和轻症组（30例）。采用竞争性ELISA法定量测定各组血清SP-A和SP-D水平变化。结果：毛细支气管炎急性期组患儿血清SP-A和SP-D水平显著高于恢复期组和对照组（均P<0.01），且恢复期组与对照组比较，血清SP-A和SP-D仍维持在较高水平（P<0.01）；重症组患儿血清SP-A和SP-D水平明显高于轻症组（P<0.01）。结论：毛细支气管炎患儿急性期血清SP-A和SP-D水平明显增高，且随病情加重而增高；临床症状缓解后，血清SP-A和SP-D水平仍然维持在较高水平。

Determination and clinical significance of serum surfactant proteins A and D in children with bronchiolitis

OBJECTIVE: To study the variation and clinical significance of serum levels of surfactant proteins A (SP-A) and D (SP-D) among children with different degrees of bronchiolitis. METHODS: Seventy children with bronchiolitis were divided into acute (n=42) and recovery phase groups (n=28). According to the severity of symptoms, the acute phase group was further divided into severe (n=12) and mild subgroups (n=30). Another 26 children who were hospitalized in the same period due to non-infectious diseases and had not undergone surgery were used as the control group. Competitive enzyme-linked immunosorbent assay was performed to measure serum levels of SP-A and SP-D in each group. RESULTS: The acute phase group had significantly higher serum levels of SP-A and SP-D compared with the recovery phase (P<0.01) and control groups (P<0.01). Compared with the control group, the recovery phase group had elevated levels of SP-A and SP-D (P<0.01). Within the acute phase group, serum levels of SP-A and SP-D in the severe subgroup were significantly higher than in the mild subgroup (P<0.01). CONCLUSIONS: Serum levels of SP-A and SP-D are significantly elevated in children with acute bronchiolitis, and severe cases have higher serum levels of SP-A and SP-D than mild cases. Even after the relief of clinical symptoms, serum levels of SP-A and SP-D remain high. These findings suggest that serum levels of SP-A and SP-D might be useful biomarkers for evaluating the severity of bronchiolitis among children.