通气功能及白三烯E4的昼夜节律与夜间支气管 哮喘的相关性研究.DOCVIP

临床医学论文-通气功能及白三烯E4的昼夜节律与夜间支气管 哮喘的相关性研究 【关键词】? 白三烯 ??? ［摘要］? 目的? 观察夜间支气管哮喘（简称哮喘）患者肺功能昼夜节律，并探讨炎症介质白三烯E4（LTE4）与夜间哮喘的关系。 方法? 依据跨夜呼气峰流量（PEF）变异率将研究对象分为夜间哮喘组（n=20）、哮喘非夜间发作组（n=22）和健康对照组（n=20），动态测定三组肺功能指标第一秒用力呼气容积（FEV1）及最大分钟通气量（MVV），同时动态监测尿液中LTE4浓度，终结果以尿LTE4浓度/尿肌酐（creatinine）浓度表示。结果? 夜间哮喘组肺功能具有明显的昼夜节律，于16时达峰值［FEV1（2.83±0.74）L，MVV（63.24±25.09）L/min］，凌晨4时降到低谷［FEV1（1.96±0.73）L，MVV（41.43±22.45）L/min］，二者差异有显著性（P＜0.05）。LTE4浓度（×10-9 g/g creatinine）9：01～15：00、15：01～21：00段在哮喘非夜间发作组［分别为（248.05±160.02）、（321.50±187.23）］显著高于健康对照组［分别为（95.61±59.94）、（162.35±85.83）］（P＜0.01）；21：01～次日9：00段夜间哮喘组（324.22±222.51）显著高于哮喘非夜间发作组（194.95±76.52）及健康对照组（201.11±68.57）（P＜0.05）。且夜间哮喘组夜间段浓度明显高于日间段（168.41±114.55）（P＜0.01）。结论? 夜间哮喘患者肺功能具有昼夜节律；白三烯多肽是哮喘的重要炎症介质，且与夜间哮喘的发生密切相关。 ??? ［关键词］? 夜间哮喘；呼气峰流量；第一秒用力呼气容积；最大分钟通气量；白三烯E4 ????? Study of correlation between circadian rhythm of leukotriene E4 and nocturnal asthma ??? Methods? According to overnight PEF variation,the subjects were divided into three groups:twenty nocturnal asthmatic patients;twenty-two asthmatic patients without nocturnal attacks and twenty control subjects.Lung function（FEV1,MVV）was measured at 04：00,08：00,16：00,22：00.Urine was collected at 9：01～15：00, ??? 15：01～21：00 and 21：01～morrow 9：00.LTE4 was measured by EIA.The concentration of creatinine was measured in-phase.And the results were expressed as LTE4/creatinine. ??? Results? In nocturnal asthmatic group lung function was highest at 16：00（FEV1 2.83±0.74 L,MVV 63.24±25.09 L/min）and lowest at 04：00（FEV11.96±0.73 L,MVV41.43±22.45 L/min），and the difference was significant（P＜0.05）.LTE4（×10-9 g/g creatinine）was significantly higher in asthmatic patients without nocturnal attacks（248.05±160.02,321.50±187.23）than in health（95.61±59.94,162.35±85.83）at 9：01～15：00 and 15：01～21：00（P＜0.01）.And at 21：01～morrow 9：00 LTE4 was significantly higher in nocturnal asthma（324.22±222.51）than that in the other two groups（194.95±76.52,201.11±68.57）（P＜0.05）.In nocturnal asthma LTE4 was significantly higher at night than it a