摘要
目的:探讨白三烯D4(LTD4)在类固醇抵抗性变应性鼻炎(AR)患者鼻分泌物和血浆的变化及LT受体拮抗剂对其的影响。方法:采用前瞻性随机对照非盲法研究。40例类固醇抵抗性AR患者(C组),随机分为CA组(口服LT受体拮抗剂——孟鲁司特钠咀嚼片10mg/次,每天1次,1周)与CB组(口服氯雷他定片10mg/次,每天1次,1周)。15例健康者为正常对照组(D组)。评定各组基线水平以及C组随访3个月后的临床症状与生活质量评分,测定鼻分泌物细胞计数与分类,并用酶联免疫吸附测定与酶免疫试验法分别测定鼻分泌物和血浆IL-5与LTD4浓度。结果:①C组鼻分泌物及血浆的LTD4水平分别为(794±305)pg和(5 219±1 185)ng/L,均显著高于D组[(347±169)pg、(2 283±489)ng/L,均P<0.05]。②鼻分泌物的LTD4水平与中性粒细胞、IL-5水平呈显著正相关(r分别为0.453、0.364,均P<0.05)。③CA组在LT受体拮抗剂治疗前、后鼻分泌物LTD4水平分别为(812±592)pg、(657±495)pg,血浆水平为(5 422±935)ng/L、(4 589±1 057)ng/L,治疗前、后比较差异无统计学意义(均P>0.05);CB组在试验前、后鼻分泌物LTD4水平分别为(776±227)pg、(860±194)pg,血浆水平为(5 074±1 850)ng/L、(6 063±2 450)ng/L,治疗前、后比较差异无统计学意义(均P>0.05)。结论:类固醇抵抗性AR患者LTD4水平增高,参与气道炎症过程。LT受体拮抗剂能显著降低鼻分泌物与血浆的LTD4水平,抗组胺治疗对此无效。
Objective：To investigate the changes of leukotriene D4（LTD4） in nasal discharge and plasma of patients with persistent allergic rhinitis（AR） and the effects of antihistamine.Method：The investigation was a prospective,randomized controlled trial.Forty AR patients（group C） were divided randomly into two subgroup.One group received oral antihistamine 10 mg everyday for one week（group CA） and another group received no loratadine tablets 10 mg everyday for one week（group CB）.Fifteen age matched healthy（group D）people were enrolled as control.The level of LTD4 and interleukin-5（IL-5） in both nasal discharge and plasma by using enzyme linked immunosorbent assay（ELISA） and enzyme immunoassay（EIA）,cell counts and cell differentials in nasal discharge,were measured before and after three month.The clinical symptom and life quality scores of group C were also investigated.Result：The concentrations of LTD4 in nasal discharge [（794±305） pg] and plasma [（5219±1185）ng/L] in group C were significantly higher than those in group D [（347±169）pg,（2283±489）ng/L,all P0.05].The level of LTD4 in nasal discharge was positively correlated with the percentage of neutrophil（r=0.453,P0.05） and IL-5（r=0.364,P0.05）.The pre-and post-therapy concentrations of nasal discharge and plasma in group CA were（812±592）pg,（657±495）pg and（5422±935） ng/L,（4589±1057）ng/L respectively;While in group CB the concentrations were（776±227）pg,（860±194）pg and（5074±1850）ng/L,（6063±2 450）ng/L,respectively.There were no significant difference either in the level of LTD4in nasal discharge or in plasma in both groups（all P0.05）.Conclusion：The results suggested that LTD4was involved in airway inflam-mation in AR.Antihistamine was not effective enough in decreasing the levels of LTD4in both nasal discharge and plasma of AR patients.
出处
《临床耳鼻咽喉头颈外科杂志》
CAS
CSCD
北大核心
2011年第8期342-346,共5页
Journal of Clinical Otorhinolaryngology Head And Neck Surgery
基金
科技部十一五科技支撑计划(No:2007BAI18B15)子课题
关键词
鼻炎
变应性
气道炎症
鼻分泌物
白三烯D4
组胺
rhinitis
allergic
airway inflammation
nasal discharge
leukotriene D4
antihistamine
