呼出气冷凝液白三烯、8异前列腺素、硝酸盐/亚硝酸盐检测在哮喘中的应用及孟鲁司特对炎症指标的影响

目的: 观察支气管哮喘患者呼出气冷凝液(EBC)中半胱氨酰白三烯C4(LTC4)、8异前列腺素(8-isoprostane)、硝酸盐/亚硝酸盐(NO₂ /NO₃)水平及孟鲁司特干预前后炎症指标的变化。 方法: 选择哮喘非急性发作期患者30例,均予孟鲁司特 10 mg,每晚一次口服,疗程1月,分别于治疗前及治疗后检测EBC中LTC4、8-isoprostane、NO₂/NO₃水平,另选择30例健康人为健康对照组。 结果: 哮喘组LTC4(55±17) ng/mL、8-isoprostane(13±9) ng/mL、NO₂/NO₃(4.2±1.2) ng/mL显著高于正常对照组(17±17)、(7±6)、(3.2±0.6) ng/mL(均P<0.01)。哮喘组治疗前LTC4 (55±17) ng/mL显著高于治疗后(38±14) ng/mL,P<0.01。哮喘组治疗前8-isoprostane (13±9) ng/mL,高于治疗后(11±6) ng/mL,但差异无统计学意义(P>0.05)。哮喘组治疗前NO₂/NO₃水平为(4.2±1.2) ng/mL,治疗后为(4.1±1.4) ng/mL,差异无统计学意义(P>0.05)。 结论: 检测哮喘患者EBC中LTC4、8-isoprostane、NO₂/NO₃水平可简便安全监测哮喘的气道炎症,孟鲁司特能降低EBC中LTC4水平,是一种有效的气道炎症抑制剂。

Value of leukotrienes C4,8-isoprostane,nitrite/nitrate in exhaled breath condensate and the effect of montelukast on inflammatory factors in asthma

AIM: To investigate the levels of leukotrienes C4(LTC4),8-isoprostane,nitrite /nitrate(NO₂/NO₃) in exhaled breath condensate of patients with asthma and the effect of inflammatory factors after montelukast treatment. METHODS: 30 patients with asthma were enrolled. They were given 10 mg montelukast once each night for one month. Before starting therapy and one month later, the levels of LTC4, 8-isoprostane, NO₂/NO₃ in exhaled breath condensate were measured. RESULTS: The levels of LTC4(55±17) ng/mL,8-isoprostane (13±9) ng/mL,and NO₂/NO₃ (4.2±1.2) ng/mL were significantly higher in the asthma group than those in the control group (17±17) ,(7±6) ,(3.2±0.6) ng/mL(P<0.01). The levels of LTC4 (55±17) ng/mL in patients with asthma before treatment was significantly higer than those in patients after treatment (38±14) ng/mL(P<0.01). Before and after treatment,the levels of 8-isoprostane,NO₂/NO₃ were (13±9),(11±6),(4.2±1.2),(4.1±1.4) ng/mL;and there were no significant differences (P>0.05). CONCLUSION: Detecting the LTC4,8-isoprostane and NO₂/NO₃ in EBC can be used to monitor asthmatic airway inflammation,which are convenient,noninvasive and safe. Montelukast can decrease the level of LTC4, which is an effective anti-inflammatory agent.