哮喘儿童发病与血液一氧化氮、肿瘤坏死因子变化的研究(1)
摘要：目的 研究哮喘儿童发病与血液一氧化氮、肿瘤坏死因子变化。方法 选择2018年1月～2019年1月在我院诊治的哮喘儿童70例作为研究对象，依据病情分为缓解组和发作组，各35例，另选取同期在我院在体检健康儿童35例作为对照组。分别检测各组血液一氧化氮(NO)、肿瘤坏死因子水平，并分析NO、肿瘤坏死因子与哮喘儿童发病的关系。结果 发作组NO水平为(46.67±18.92)μmol/L、肿瘤坏死因子水平为(198.77±42.29)ng/L，均高于缓解组的(32.41±14.22)μmol/L、(192.42±37.83)ng/L和对照组(29.54±14.34)μmol/L、(164.51±31.11)ng/L，差异有统计学意义(P<0.05);缓解组NO、肿瘤坏死因子水平高于对照组，差异有统计学意义(P<0.05);哮喘组肿瘤坏死因子水平与NO水平呈正相关(r=0.36、0.48，P<0.05)。结论 NO、肿瘤坏死因子参与哮喘发作期气道炎症的形成，肿瘤坏死因子水平与NO水平密切相关，肿瘤坏死因子可作为哮喘缓解期患儿炎症持续的重要指标，具有重要的临床研究意义。
关键词：哮喘儿童;一氧化氮;腫瘤坏死因子
Abstract：Objective To study the pathogenesis of children with asthma and changes of blood nitric oxide and tumor necrosis factor.Methods A total of 70 children with asthma who were treated in our hospital from January 2018 to January 2019 were enrolled in the study. According to the condition， they were divided into the remission group and the seizure group， 35 cases for each roupg， and another 35 cases of healthy children in our hospital during the same period as a control group. The levels of blood nitric oxide (NO) and tumor necrosis factor were measured in each group， and the relationship between NO， tumor necrosis factor and childhood asthma was analyzed.Results The level of NO in the seizure group was (46.67±18.92) μmol/L， and the level of tumor necrosis factor was (198.77±42.29) ng/L， which was higher than that in the remission group (32.41±14.22) μmol/L， (192.42±37.83) ng/ L and the control group (29.54±14.34) μmol/L， (164.51±31.11) ng/L， the difference was statistically significant (P<0.05); the NO and tumor necrosis factor levels in the remission group were higher than the control group， the difference was statistically significant(P<0.05); the level of tumor necrosis factor was positively correlated with NO level in asthma group(r=0.36，0.48，P<0.05).Conclusion NO and tumor necrosis factor are involved in the formation of airway inflammation during asthma attack. The level of tumor necrosis factor is closely related to the level of NO. Tumor necrosis factor can be used as an important indicator of inflammation persistence in children with asthma remission. It has important clinical significance.
Key words：Children with asthma;Nitric oxide;Tumor necrosis factor
儿童哮喘(asthmatic)是临床常见的呼吸道疾病，尤其是小儿哮喘的发病率较高，严重影响儿童的健康成长。儿童哮喘具有长期反复发作的特点，如果不及时治疗和控制，会造成不可逆的危害，严重时会发展成为肺气肿、肺心病，临床单纯药物治疗难以治愈[1]。而肿瘤坏死因子(TNF-α)是一种多小影响生物活性分子，在炎症持续与发生中具有重要作用。肿瘤坏死因子可活化巨噬细胞诱生NO合成酶，进而产生大量NO，从而造成局部组织损伤。研究已发现哮喘儿童支气管灌洗液这肿瘤坏死因子增加，呼出气中NO高于正常人[2]。但是对于血液中NO水平的变化研究较少。本文作者结合2018年1月～2019年1月在我院诊治的70例哮喘儿童临床资料，分析哮喘儿童发病与NO、肿瘤坏死因子水平变化的关系，进一步探究NO、肿瘤坏死因子在哮喘儿童气道炎症中的作用，为临床治疗哮喘儿童提供可靠的依据，现报告如下。(王洪峰)