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目的探讨尿白三烯E4(LTE4)检测在监测儿童支气管哮喘(哮喘)转归中的作用及哮喘患儿尿LTE4与呼吸道阻力(Rint)、外周血嗜酸性粒细胞(EOS)计数的关系。方法选取30例1～5岁未服用过白三烯受体拮抗剂孟鲁司特钠的哮喘患儿(哮喘组),分为急性发作期、慢性持续期(服用孟鲁司特钠1个月)及临床缓解期(服用孟鲁司特钠3个月);另选取20例健康儿童作为健康对照组。采用竞争性ELISA法检测4组儿童尿LTE4水平,并测定Rint与EOS。结果哮喘组急性发作期、慢性持续期及临床缓解期患儿尿LTE4及Rint水平均明显高于健康对照组(Pa<0.01);3个哮喘组尿LTE4、Rint及外周血EOS比较差异均有统计学意义(F=870.08、496.58、195.98,Pa<0.01)。急性发作期哮喘患儿的尿LTE4水平与Rint无相关性(r=0.11,P>0.05),与EOS亦无相关性(r=-0.12,P>0.05)。结论哮喘患儿急性发作期尿LTE4水平明显升高,随着哮喘症状的好转,尿LTE4水平也逐渐下降;动态监测哮喘患儿尿LTE4水平,可以为儿童哮喘的临床诊断、白三烯受体拮抗剂治疗哮喘的疗效评估提供客观依据。
Objective To investigate the role of urinary leukotriene E4 (LTE4) in monitoring the outcome of children with bronchial asthma (asthma) and the relationship between urinary LTE4 and Rint and eosinophil count in children with asthma. Methods Thirty asthmatic children (asthma group), untreated with montelukast sodium as leukotriene receptor antagonist, were enrolled in this study. The patients were divided into two groups: acute exacerbation and chronic exacerbation (1 montelukast sodium Month) and clinical remission (taking montelukast sodium for 3 months); another 20 healthy children were selected as healthy control group. Urinary LTE4 levels were measured in 4 groups of children by competitive ELISA and Rint and EOS were measured. Results The urinary LTE4 and Rint levels in children with acute exacerbation, chronic persistent disease and clinical remission in asthma group were significantly higher than those in healthy control group (Pa <0.01). There were significant differences in urinary LTE4, Rint and peripheral blood EOS among the three asthma groups Statistical significance (F = 870.08, 496.58, 195.98, Pa <0.01). There was no correlation between urinary LTE4 level and Rint in children with acute asthma (r = 0.11, P> 0.05) and no correlation with EOS (r = -0.12, P> 0.05). Conclusion The level of LTE4 in acute asthmatic children with acute exacerbation of urinary excretion was significantly increased. With the improvement of asthma symptoms, the level of urinary LTE4 also gradually decreased. The dynamic monitoring of urinary LTE4 levels in children with asthma could be used for the clinical diagnosis of childhood asthma, leukotriene receptor Antagonists for the evaluation of the efficacy of asthma provide an objective basis.