目的 研究白三烯C4合成酶(LTC4S)基因rs730012位点多态性与呼吸道合胞病毒(RSV)感染的毛细支气管炎易感性及孟鲁司特钠疗效的关系,为毛支患儿的临床个体化治疗研究提供一定参考。方法 选取2018年3月-2019年6月南阳市第二人民医院确诊的RSV毛细支气管炎患儿120例作为病例组,健康体检儿80例为对照组。检测两组受试儿LTC4S rs730012位点基因型;病例组在常规治疗的同时口服孟鲁司特钠连续治疗2周,观察不同基因型病例组患儿临床表现的差异,检测治疗前后其血清半胱氨酰白三烯(CysLTs)、尿白三烯E4(LTE4)、嗜酸粒细胞阳离子蛋白(ECP)水平以及潮气呼吸肺功能参数的变化。结果 LTC4S基因的rs730012位点基因型及等位基因频率在病例组和对照组间总体分布差异无统计学意义(χ2=0.797,0.624,P>0.05)。治疗后AC/CC组患儿1周后临床症状评分、咳嗽缓解时间、喘息、哮鸣音消失时间以及住院时间上均显著低于AA组(t=3.552、2.284、3.446、2.716、2.871,P<0.05);治疗1周后,AC/CC组患儿血清CysLTs、尿LTE4、血清ECP水平均显著低于AA组(t=4.653、5.917、9.933,P<0.001),肺功能指标潮气量、TPTEE/TE和VPEE/VE也显著高于AA组(t=2.090、2.104、2.312,P<0.05)。结论 RSV毛细支气管炎患儿LTC4S基因多态性与RSV毛细支气管炎易感性无相关性,但可能与孟鲁司特钠疗效有关,AC/CC基因型患儿疗效相对优于AA型。
Abstract
Objective To investigate the relationship between polymorphism of leukotriene C4 synthase (LTC4S) gene rs730012 and susceptibility of respiratory syncytial virus (RSV) bronchiolitis and the efficacy of montelukast sodium. Methods A total of 120 children diagnosed with RSV bronchiolitis in Nanyang Second General Hospital were selected as case group,and 80 healthy children were selected as control group. Genotypes of LTC4S rs730012 in two groups were detected. The case group was treated with Montelulast sodium orally for 2 weeks based on the routine treatment. The differences in clinical manifestations of children in the case group with different genotypes were analyzed,and the changes in serum cysteamine leukotriene (CysLTs),urinary leukotriene E4(LTE4),eosinophi cationic protein (ECP) levels and moisture respiratory pulmonary function parameters were detected before and after treatment. Results The distribution of genotype and allele frequency of LTC4S rs730012 showed no significant difference between the case group and control group (χ2=0.797,0.624,P>0.05). After treatment,the clinical symptom score after one week,the duration of cough,breathing and wheezing and the hospitalization days in AC/CC group were significantly lower than those in AA group(t=3.552,2.284,3.446,2.716,2.871,P<0.05).After one week of treatment,the levels of serum CysLTs,urine LTE4 and ECP in the AC/CC group were significantly lower than those in AA group(t=4.653,5.917,9.933,P<0.001).Additionally, the lung function indexes like tidal volume,TPTEE/TE and VPEE/VE were also significantly higher than those of AA group(t=2.090,2.104,2.312,P<0.05). Conclusions There was no correlation between LTC4S gene polymorphism and susceptibility in children with RSV bronchiolitis,but it may be related to the efficacy of montelulast sodium. The efficacy of RSV children with AC/CC genotype is relatively better than that of RSV children with AA genotype.
关键词
毛细支气管炎 /
白三烯C4合成酶 /
基因多态性 /
孟鲁司特钠
Key words
bronchiolitis /
leukotriene C4 synthase /
polymorphism /
montelukast sodium
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