哮喘患儿外周血半胱氨酰白三烯水平及5-脂氧合酶激活蛋白mRNA基因表达水平及其临床意义

摘要

目的 探讨哮喘患儿外周血半胱氨酰白三烯( CysLTs)水平及5-脂氧合酶激活蛋白( FLAP) mRNA基因表达水平及其临床意义. 方法 哮喘患儿(5岁及以下)40例,按病情等级划分轻、中、重、危重组,另外选取10名健康儿童作对照组. 哮喘患儿随机分为常规治疗组及白三烯( LTs)拮抗剂干预组,每组20例. 分别于入院24 h内、治疗第10天、3个月、1年、2年抽取外周血测定 CysLTs 水平及 FLAP mRNA/β-action mRNA 的相对数值,并记录患儿病情等级和疗效情况.结果 哮喘患儿的入院时CysLTs水平及FLAP mRNA/β-action mRNA的相对数值均高于对照组(P<0.05),CysLTs水平及FLAP mRNA/β-action mRNA与病情程度呈正相关性(P<0.05). 治疗第10天、3个月、1年及2年,LTs拮抗剂干预组的病情分级均轻于常规治疗组,但差异无统计学意义(P>0.05),疗效均优于常规治疗组(P<0.05);在治疗后各观察时间点,LTs拮抗剂干预组CysLTs水平及FLAP mRNA/β-action mRNA的相对数值均显著低于常规治疗组(P<0.05). 结论 CysLTs及FLAP mRNA水平与哮喘的病情呈正相关性,CysLTs可能成为研究哮喘发病和药物治疗的重要指标;采用LTs拮抗剂联合ICS治疗患儿哮喘具有协同作用,有效控制CysLTs及FLAP mRNA水平.%Objective To investigate the peripheral blood levels of cysteinyl leukotrienes(CysLTs) and 5-lipoxygenase activating protein(FLAP) mRNA in children with asthma and their clinical significance.Methods Forty children(aged 5 years or younger) with asthma were divided into mild, moderate, severe and critical groups according to the severity of asthma.And 10 healthy children were selected as control group.All children with asthma were randomly divided into conventional treatment group(n=20) and leukotrienes(LTs) antagonist group( n=20) .The peripheral blood samples were collected within 24 hours of admission,10 days,3 months,1 year and 2 years after treatment,respectively,for determining the level of CysLTs and the relative value of FLAP mRNA/β-action mRNA,and the severity of asthma and efficacy were recorded.Results Children with asthma obtained a higher level of CysLTs and higher relative value of FLAP mRNA/β-action mRNA on admission compared to the controls(P<0.05),and the level of CysLTs and the relative value of FLAP mRNA/β-action mRNA positively correlated with the severity of asthma(P<0.05).Ten days,3 months,1 year and 2 years after treatment,the severity of asthma in the LTs antagonist group was milder compared to that in the conventional treatment group,with no significant difference(P>0.05),but the efficacy of LTs antagonist group was superior to that of conventional treatment group(P<0.05).The levels of CysLTs and the relative values of FLAP mRNA/β-action mRNA in the LTs antagonist group were significantly lower than those in the conventional treatment group at all time points after treatment(P<0.05).Conclusion The levels of CysLTs and FLAP mRNA both positively correlate with the severity of asthma,and CysLTs may become an important index for the researches on pathogenic mechanism and medication of asthma.LTs antagonist combined with ICS has a synergistic effect on children with asthma,thus effectively controling the levels of CysLTs and FLAP mRNA.