哮喘患儿血浆一氧化氮、环磷酸腺苷/环磷酸鸟苷比值变化的临床意义

目的　研究支气管哮喘患儿血浆一氧化氮 (NO)、环磷酸腺苷 (cAMP) /环磷酸鸟苷 (cGMP)比值变化及其临床意义。方法　采用硝酸还原酶法和放射免疫法测定哮喘患儿 4 0例急性期和缓解期血浆NO3 -/NO2 -、cAMP及cGMP水平与cAMP/cGMP比值变化 ,并设 2 3例健康儿童为对照组。结果　 1.哮喘患儿急性期血浆NO3 -/NO2 -水平显著高于缓解期和对照组 (P均 <0 .0 1)。 2 .哮喘患儿急性期血浆cGMP水平明显高于缓解期 (P <0 .0 5 ) ,显著高于对照组 (P <0 .0 1)。 3.哮喘患儿急性期血浆cAMP明显低于缓解期和对照组 (P均<0 .0 1)。 4 .哮喘患儿急性期cAMP/cGMP比值显著低于缓解期和对照组 (P均 <0 .0 1)。 5 .缓解期血浆NO3 -/NO2 -和cGMP水平下降 ,cAMP水平上升及其cAMP/cGMP比值与对照组相比 ,差异无显著性 (P均 >0 .0 5 )。6 .哮喘患儿急性期血浆NO3 -/NO2 -与cGMP水平呈正相关 (r =0 .4 0 1　P <0 .0 1)。结论　血浆内源性NO、cAMP、cGMP可能参与哮喘的发病机制 ,血浆NO、cAMP/cGMP比值变化可作为监测和指导哮喘患儿疗效和评价哮喘药物疗效的较好生化指标。

Clinical significance of plasma nitric oxide and cyclic adernosine monophosphate/cyclic guanosine monophosphate ratio in children with asthma

Objective To study the clinical significance and changes of plasma nitric oxide (NO) and cyclic adernosine monophosphate(cAMP)/cyclic guanosine monophosphate(cGMP) ratio in children with asthma.Methods NO,cAMP,cGMP levels and changes of cAMP/cGMP in 40 asthmatic children in acute attack stage and restoration stage and in 23 health children were measured by nitric acid reductase method and radioimmunoassay.Results 1.the amount of NO 3-/NO 2-in the plasma of asthmatic children in acute attack stage was obviously higher than that in restoration stage and in normal control group(P<0.01);2.cGMP levels in plasma of asthmatic children in acute attack stage were significantly higher than those in restoration stage(P<0.05)and in normal control group(P<0.01);3.Plasma cAMP levels in acute attack stage were obviously lower than those in restoration stage and in normal group(P< 0.01);4.the cAMP/cGMP ratio of asthmatic children in acute attack stage was significantly lower than that in restoration stage and in normal group(P<0.01);5.plasma NO 3-/NO 2-,cAMP and cGMP levels and the cAMP/cGMP ratio in restoration stage had no obvious changes compared with those in normal control group (P>0.05);6.the results of linear correlation analysis showed that there were positive correlations between plasma NO 3-/NO 2- and plasma cGMP levels in acute attack stage (r=0.401 P<0.01).Conclusions These results indicate that plasma NO and cAMP,cGMP levels are associated with the pathogenesis of bronchical asthma in children. This study suggests that plasma NO 3-/NO 2- levels and cAMP/cGMP ratio may be a helpful index for the evaluation of severity and therapeutic effects in asthmatic children.