反复肺炎合并支气管哮喘患儿自三烯E4和自三烯B4水平及临床意义

目的测定反复肺炎合并支气管哮喘患儿尿白三烯E2（leukotrieneE4，LTE4）和血清白三烯B4（leukotriene B4，LTB4）水平，探讨LTE4、LTB4在反复肺炎和支气管哮喘之间的关系。方法收集30例反复肺炎合并支气管哮喘患儿（A组）、21例反复肺炎不伴有支气管哮喘患儿（B组）以及22例健康对照者的尿液以及血清。处理后进行血细胞计数和分类，应用酶联免疫吸附法检测尿LTE4和血清LTB4、白细胞介素-8（interleukin-8，IL-8）水平，并分析LTE4与LTB4、IL-8、中性粒细胞之间以及LTB4与LTE4、IL-8、中性粒细胞之间的相关性。结果①尿LTE4表达水平，A组为（385±43）pg／ml，B组为（232±66）Pg／ml，均显著高于健康对照组（153±51）pg／ml（P〈0．05），而且A组水平显著高于B组水平（P〈0．05）。②血清LTB4表达水平，A组为（151±28）pg／ml，B组为（86±32）pg／ml，均显著高于健康对照组（65±25）pg／ml（P〈0．05），而且A组水平显著高于B组水平（P〈0．05）。③血清IL-8表达水平，A组为（124±13）pg／ml，B组为（85±13）pg／ml，均显著高于健康对照组（56±25）pg／ml（P〈0．05），而且A组水平显著高于B组水平（P〈0．05）。④血中性粒细胞比例表达水平，A组为0．58±0．07，B组为0．52±0．04，均显著高于健康对照组0．28±0．08（P〈0．05），而且A组水平显著高于B组水平（P〈0．05）。⑤尿LTE。表达水平与血清LTB4、IL-8、中性粒细胞比例表达水平呈正相关（P〈0．05）。血清LTB4表达水平也与尿LTE4、血清IL-8、中性粒细胞比例表达水平呈正相关（P〈0．05）。结论LTB4和LTE4在反复肺炎和支气管哮喘之间扮演着桥梁的角色，降低LTB4和LTE4水平或许可以切断两者之间的恶性循环。

Expression and Clinical Significance of Leukotriene E4 and B4 Levels in Children with Recurrent Pneumonia Complicated with Bronchial Asthma

Objective To measure the levels of urinary leukotriene E4 （LTE4） and serum leukotriene B4 （LTB4） in children with recurrent pneumonia complicated with bronchial asthma; and to explore the relationship of LTE4, LTB4 between recurrent pneumonia and bronchial asthma. Methods Urine and serum samples consisted of 30 children with complicated with bronchial asthma （group A）, 21 children with recurrent pneumonia （group B）, and 22 healthy controls; and the collected samples were sent to blood count and classification. Enzyme-linked immunosorbent assay （ELISA） was used to detect the levels of urine LTE4, serum LTB4 and interleukin-8 （IL-8）, and analyze the correlation between LTE4 and LTB4, IL-8, neutrophils, and the correlation between LTB4 and LTE4, IL-8, neutrophils. Results （1）The expression of urinary LTE4 varied among these groups; urinary LTE4 was expressed in group A at high levels （385 ± 43 pg/ml）, and in group B at low level （232 ± 66 pg/ml）, while in healthy controls＇ group at low levels （153 ± 51 pg/ml）, with significant difference between the former two groups and healthy controls group （all P〈0.05）; the same as group A and group B （P〈0.05）. （2）The serum LTB4 level of group A, group B and healthy controls were （151 ± 28） pg/ml, （86 ± 32） pg/ml and （65 ± 25） pg/ml, respectively （/＇〈0.05）. The level of group A and group B were both significantly higher than healthy controls （P〈0.05）, while the level of group A was significantly higher than group B （P〈0.05）. （3）The expression of IL-8, which was （124 ± 13） pg/ml in group A, （85 ± 13） pg/ml in group B, were both significantly higher than healthy controls＇ group （153 ± 51 pg/ml, P〈0.05）. Group A＇s level was significantly higher than group B＇s （P〈0.05）. （4）The neutrophils＇ level of the three groups were respectively 0.58 ± 0.07 （group A）, 0.52 ± 0.04 （group B）, 0.28 ± 0.08 （healthy controls）. Both group A and group B excelled healthy controls group with statistical significance （P〈0.05）, and group A excelled group B （P〈0.05）. （5）Expression level of urinary LTE4 was positively correlated with expression levels of serum LTB4, IL-8 and neutrophils＇ percentage（P〈0.05）, the same as serum LTB4 with urine LTE4, serum IL-8 and neutrophils＇ percentage （P 〈0.05）. Conclusion LTB4 and LTE4 play bridging roles between recurrent pneumonia and bronchial asthma. Lowering LTB4 and LTE4 levels may be able to cut offvicious circle between them.