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兒童急性細支氣管炎血清Lipoxin A4之濃度變化

Serum Level of Lipoxin A4 among Young Children with Acute Bronchiolitis

摘要


目的:lipoxin A4的濃度高低與氣喘病患有相關性。若幼兒的急性細支氣管炎是日後轉變成氣喘的前兆,則急性細支氣管炎的致病機轉是否與氣喘類似與lipoxin A4的合成缺陷有關,可否利用血清中lipoxin A4的濃度來預估急性細支氣管炎患者日後演變成氣喘的可能性。方法:於台北市立聯合醫院陽明院區小兒科總計收集了80例孩童病患,包括46例幼年(小於兩歲)急性細支氣管炎患者。22例幼年(小於兩歲)腸胃疾病或其它疾病患者,以及12例大於兩歲臨床診斷為氣喘患者,分別採取靜脈血液檢測血清中lipoxin A4的數值,檢測並探討這三組孩童病患之間的相異度。同時探討急性細支氣管炎患者與氣喘患者之間是否有相關性。結果:我們的研究結果雖然顯示幼年急性細支氣管炎與腸胃疾病或其它疾病患者,以及臨床診斷為氣喘患者,其血清中lipoxin A4的濃度統計學上並沒有顯著差異,但根據Multiple regression的分析,顯示出lipoxin A4的濃度和年齡是有相關的。結論:雖然lipoxin A4的濃度在幼年急性細支氣管炎與兒童氣喘患者間不具統計學意義,然而假設隨年齡的增長其lipoxin A4的濃度也增高為架構,則可以推論兒童氣喘實驗組的lipoxin A4的濃度是相對較低的,或許可能與成人氣喘的病理變化是類同的。

並列摘要


Objective: The purpose of present study is to investigate the serum level of lipoxin in young children with acute bronchiolitis and whether it can be used as an early predictive diagnostic method for asthma. Methods: Seventy-nine children were recruited. Forty-six children with acute bronchiolitis formed the experimental group and the other children, who formed control groups, consisted of twenty-two with acute gastroenteritis and eleven with asthma. We excluded subjects with a priori known premature birth (defined as birth before 36 weeks of gestation), heart disease, lung disease, immunosuppression, immunodeficiency, critically ill children and children who had been treated with corticosteroids in the previous 14 days. Samples of whole blood from all individuals were collected and the level of lipoxin A4 was assayed for each sample. These finding were compared across the three disease groups. Correlation analysis was also performed. Results: Preliminary data showed that there was no significant difference between the acute bronchiolitis, acute gastroenteritis and asthma groups in terms of the serum levels of lipoxin A4, but that there was a positive correlation with age. Conclusion: The serum level of lipoxin A4 cannot be used as an early predictive diagnostic method for asthma among young children with acute bronchiolitis. If we accept the hypothesis that children of different ages show a consistent variation in the level of lipoxin A4, the serum levels of lipoxin A4 in children with asthma are relative lower than the other two groups, which is similar to the situation when adults have asthma.

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