支气管肺发育不良患儿尿LTE4水平变化的临床意义

目的 连续测定高危早产儿出生后到6个月各阶段尿中白三烯E4（LTE4）的水平,探讨其与支气管肺发育不良患儿的关系。方法 选择在本院住院的高危早产儿15例,新生儿15例。早产儿留取第2、7、14、28天的尿液,新生儿取第2、7、14、28天尿液作对照,采用酶联免疫吸附（ELISA）法检测LTE4水平。结果 正常新生儿的LTE4维持在较低的水平,早产儿一周内的LTE4水平也变化不大,14天时早产儿LTE4水平开始上升,与正常新生儿相比二者有显著性差异（P0.05;7天的两组数据相比t值为6.4,P50mmHg）,胸片异常。Shannon建议采用校正胎龄36周仍需氧定义BPD,认为此定义更能准确地预测肺的预后。因此BPD的早期诊断标准并不正确。而有人在BPD患儿的婴儿后期发现与健康同龄婴儿相比,其尿中白三烯E4水平增高,提示LTE4可能在BPD的发生、发展中起到一定作用[1]。

Changes of Urinary LTE4 Level in Children with Bronchopulmonary Dysplasia:Clinical Significance

Objective To observe the urine leukotrienes E4 levels（LTE4） of high-risk premature babies from being born to six months and explore the relationship between bronchopulmonary dysplasia（BPD ） and the urine LTE4 level. Methods According to the diagnosis criteria, the urinary LTE 4 levels of two groups（one group included 15 premature children and the other 15 full-term children） were detected on Day 2,14 and 28 respectively by enzyme-linked immunosorbent assay（ELISA） method, and the statistical analysis was made by using SPSS15.0 software. Results The urinary LTE4 of full-term children was maintained at a relatively lower level. The urinary LTE 4 level of premature children showed little change within the first 7 days,but after 14 days,the level began to rise, remarkably higher than that of the full-term babies（P〈0.01 ）, and the urinary LTE4 of premature children was still at a higher level after 28 days（P〈 0.01 ）. Conclusion The urinary LTE4 is an important inflammatory mediator of asthma,and closely related to children oxygen uptake, breathing machine and lung immaturity. To observe the urine LTE4 level of premature children is important for the early diagnosis of, and the guidance of treatment of,BPD and the improvement its prognosis.