【作者】 李莉；

【导师】 王亚亭；

【作者基本信息】 安徽医科大学 ， 儿科学， 2017， 硕士

【摘要】 目的:通过检测不同分期哮喘儿童呼出气冷凝液(exhaled breath condensate,EBC)中白三烯B4(leukotriene B4,LTB4)和嗜酸性粒细胞趋化因子(eotaxin,CCL11)水平,探索EBC中LTB4和CCL11两种生物标记物在儿童哮喘病情日常监测中的应用。并分析两者的相关性,探索哮喘的发病机制。方法:收集自2016.02至2016.06期间就诊于安徽医科大学一附院门诊的64例哮喘患儿,其中急性发作期33例、慢性持续期18例、缓解期13例,选取同时期8例健康儿童作对照。采用美国Respiratory Research公司生产的R-Tube装置收集每个实验对象的EBC,采用英国abcam公司生产的双抗体夹心酶联免疫吸附试验(enzyme-linked immunosorbent assay,ELISA)试剂盒,检测每个标本中LTB4和CCL11水平。分析两种生物标记物在哮喘急性发作组、持续对照组、临床缓解组和健康对照组儿童之间的差异,同时研究两种标记物之间的相关性。结果:(1)EBC中LTB4水平从高到低依次为发作组(70.89±8.31,pg/ml)、持续组(35.27±6.61,pg/ml)、缓解组(24.58±4.90,pg/ml)、对照组(15.53±3.24,pg/ml),各组间差异有统计学意义(P<0.05)。(2)EBC中CCL11水平在哮喘发作组(3.38±0.65,pg/ml)最高,其次为持续组(2.46±0.52,pg/ml),缓解组(0.90±0.36,pg/ml)和对照组(0.71±0.26,pg/ml),除缓解组与对照组外,其他各组差异都有统计学意义。(3)各组EBC中LTB4、CCL11水平均无相关性(P>0.05)。结论:EBC中LTB4水平可区分出儿童哮喘各个分期的气道炎症状态,EBC中CCL11水平除了不能区分缓解期与健康儿童,可区分出急性发作期和慢性持续期的气道炎症状态。故EBC中两者的检测有应用于哮喘儿童临床日常病情监测的潜能。两种生物标记物在EBC中检测结果并未显示有相关性。更多还原

【Abstract】 Objective:To investigate two markers,leukotriene B4(LTB4)and eotaxin(CCL11),in exhaled breath condensate(EBC)on the evaluation of asthma in children.Methods:64 Asthmatic children who visit the First Affiliated Hospital of Medical University Of Anhui during the period of 2016.02-2016.06 were enrolled,including 33 with acute asthma exacerbation,18 with chronic asthma,13 with resolving asthma,and 8 healthy children as controls.The EBC of each subject was collected using R-Tube device produced by Respiratory company of America.LTB4 and CCL11 were detected by double antibody sandwich enzyme-linked immunosorbent assay(ELISA)in each sample.These ELISA kits produced by British Abcam company.The differences between the two biomarkers in acute exacerbation of asthma,the control group,the clinical remission group and the healthy control group were analyzed,and the correlation between the two markers was studied.Results:(1)The levels of LTB4 in EBC from the highest to the lowest were: Acute asthma exacerbation group(70.89 ± 8.31 pg/ml),chronic asthma group(35.27 ± 6.61pg/ml),resolving asthma group(24.58 ± 4.90 pg/ml),and control group(15.53 ± 3.24 pg/ml).There was significant statistical difference among the groups(P < 0.05).(2)The level of CCL11 in EBC was the highest in the acute asthma exacerbation group(3.38 ± 0.65 pg/ml),followed by the chronic asthma group(2.46 ± 0.52 pg/ml),the resolving asthma group(0.90 ± 0.36 pg/ml),and the control group(0.71 ± 0.26 pg/ml).The difference between the resolving asthma group and the control group was not statistically significant.(3)There was no correlation between the levels of LTB4 and CCL11 in each group(P > 0.05).Conclusions:The levels of LTB4 and CCL11 in EBC can reflect the status of airway inflammation in asthma and its control.They have a certain value in the assessment of asthma in children.The detection results of two biomarkers in EBC showed no correlation.更多还原