CAJ | 학술논문

目的探讨慢性荨麻疹患者血浆中调节激活正常T细胞表达和分泌的细胞因子(RANTES)、嗜酸粒细胞趋化因子(eotaxin)、TNF-α及白三烯B4(LTB4)的水平及其意义.方法对41例慢性荨麻疹患者进行临床评价,按症状积分将病情分为轻型、中型、重型3级.应用咪唑斯汀10 mg每日1次,连续治疗4周.采用ELISA法测定20例健康志愿者与41例患者治疗前后血浆中RANTES、eotaxin、TNF-α与LTB4的水平.结果 ①慢性荨麻疹组血浆中RANTES、eotaxin、TNF-α和LTB4水平分别为(52.5 ±10.2)μg/L、(58.4±16.1)μg/L、(35.1±9.6)ng/L和(109.4±21.7)ng/L,健康对照组水平分别为(33.7±9.4)μg/L、(48.3±13.6)μg/L、(21.3±8.9)ng/L和(77.8±11.6)ng/L,两组比较差异均有统计学意义,P值分别<0.01、<0.05、<0.01、<0.01.②血浆RANTES、eomxin、TNF-α、LTB4水平与临床表现的相关性分析显示:中、重型慢性荨麻疹患者的RANTES、eotaxin、TNF-α与LTB4血浆水平高于轻型患者,差别均有统计学意义,P<0.05;重型患者的RANTES、eotaxin、TNF-α与LTB4血浆水平较中型患者略有增高,但差异均无统计学意义,P>0.05.③咪唑斯汀治疗后慢性荨麻疹组血浆中RANTES、eotaxin、TNF-α和LTB4水平较前明显下降,分别为(36.3±8.9)μg/L、(46.3±10.2)μg/L、(23.2±7.5)ng/L和(83.1±14.2)ng/L,与治疗前比较差异有统计学意义,P值均<0.01,与健康对照组比较P值均>0.05.结论慢性荨麻疹患者血浆RANTES、eotaxin、TNF-α吨与LTB4水平升高,并与病情的严重程度呈正相关趋势,咪唑斯汀治疗后血浆中RANTES、eotaxin、TNF-α和LTB4水平较前明显下降,提示RANTES、eotaxin、TNF-α与LTB4在慢性荨麻疹的发病过程中可能起一定作用.
목적 탐토만성담마진환자혈장중조절격활정상T세포표체화분비적세포인자(RANTES)、기산립세포추화인자(eotaxin)、TNF-α급백삼희B4(LTB4)적수평급기의의.방법 대41례만성담마진환자진행림상평개,안증상적분장병정분위경형、중형、중형3급.응용미서사정10 mg매일1차,련속치료4주.채용ELISA법측정20례건강지원자여41례환자치료전후혈장중RANTES、eotaxin、TNF-α여LTB4적수평.결과 ①만성담마진조혈장중RANTES、eotaxin、TNF-α화LTB4수평분별위(52.5 ±10.2)μg/L、(58.4±16.1)μg/L、(35.1±9.6)ng/L화(109.4±21.7)ng/L,건강대조조수평분별위(33.7±9.4)μg/L、(48.3±13.6)μg/L、(21.3±8.9)ng/L화(77.8±11.6)ng/L,량조비교차이균유통계학의의,P치분별<0.01、<0.05、<0.01、<0.01.②혈장RANTES、eomxin、TNF-α、LTB4수평여림상표현적상관성분석현시:중、중형만성담마진환자적RANTES、eotaxin、TNF-α여LTB4혈장수평고우경형환자,차별균유통계학의의,P<0.05;중형환자적RANTES、eotaxin、TNF-α여LTB4혈장수평교중형환자략유증고,단차이균무통계학의의,P>0.05.③미서사정치료후만성담마진조혈장중RANTES、eotaxin、TNF-α화LTB4수평교전명현하강,분별위(36.3±8.9)μg/L、(46.3±10.2)μg/L、(23.2±7.5)ng/L화(83.1±14.2)ng/L,여치료전비교차이유통계학의의,P치균<0.01,여건강대조조비교P치균>0.05.결론 만성담마진환자혈장RANTES、eotaxin、TNF-α둔여LTB4수평승고,병여병정적엄중정도정정상관추세,미서사정치료후혈장중RANTES、eotaxin、TNF-α화LTB4수평교전명현하강,제시RANTES、eotaxin、TNF-α여LTB4재만성담마진적발병과정중가능기일정작용.
Objective To investigate the plasma levels of regulated upon activation normal T cell expressed and secreted (RANTES), eotaxin, tumor necrosis factor (TNF)-α and leukotriene B4 (LTB4) in patients with chronic urticaria and their roles in the pathogenesis of chronic urticaria. Methods Forty-one patients with chronic urticaria were included into this study along with 20 normal human controls. Patients were graded into three groups, I.e. Mild group (n = 11), moderate group (n = 21) and severe group (n = 9), according to their symptom score. All patients were treated with mizolastine 10 mg per day for 4 weeks. ELISA was used to study the plasma levels of RANTES, eotaxin, TNF-α and LTB4 in normal controls and patients before and after treatment. Results The plasma levels of RANTES, eotaxin, TNF-α and LTB4 were (52.5 ± 10.2) g/L, (58.4 ± 16.1) g/L, (35.1 ± 9.6) ng/L and (109.4 ± 21.7) ng/L, respectively, in untreatedpatients with chronic urticaria, compared to (33.7 ± 9.4) g/L, (48.3 ± 13.6) g/L, (21.3 ± 8.9) ng/L and(77.8 ± 11.6) ng/L, respectively, in normal controls(P < 0.01, 0.05, 0.01, 0.01, respectively). Increased plasmalevels of RANTES, eotaxin, TNF-α and LTB4 were observed in patients with moderate or severe chronic urticaria compared with those with mild chronic urticaria (both P < 0.05), whereas there was no significant difference between patients with severe and mild chronic urticaria (P < 0.05). After treatment with mizolas-fine the plasma levels ofRANTES, eotaxin, TNF-α and LTB4 were (36.3 ± 8.9) g/L, (46.3 ± 10.2) g/L, (23.2 ± 7.5) ng/L and (83.1 ± 14.2) ng/L respectively, significantly lower than those in patients before treatment (all P < 0.01), but showed no difference from those in normal controls (all P > 0.05). Conclu-sions The plasma levels of RANTES, eotaxin, TNF-α and LTB4 are elevated in patients with chronic urticaria, and they exhibits a positive correlation tendency with disease activity. After treatment with mizolastine, a significant decrease is observed in the plasma levels of RANTES, eotaxin, TNF-α and LTB4, which hints that RANTES, eotaxin, TNF-α and LTB4 may play a certain role in the pathogenesis of chronic urticaria.