哮喘联盟

   摘要
   背景：被动吸烟与儿童哮喘控制较差有关，但机制尚不清楚。白三烯参与了哮喘的致病过程，并且在主动吸烟的成人中白三烯合成有所增加。
   目的：在有或无哮喘的儿童中评价被动吸烟（检测尿液可替宁）是否能增加白三烯的产生。
   方法：本试验是一项前瞻性、横断面研究，稳定、间歇性哮喘（无恶化）患儿和健康儿童入选。进行肺活量检测和检测尿液可替宁和白三烯E4（LTE4）水平。对入选两组的受试者进行平衡，均包含有和无被动吸烟的受试者。
   结果：90名平均年龄为9岁（5～13岁）的儿童（49名哮喘患儿，41名对照者，54.4%的女性）入选本研究。尿液LTE4浓度随着可替宁浓度的增加而增加（rS=0.23, p=0.03）。LTE4与体重指数（BMI）相关（rS=0.30, p=0.004）。多因素回归分析显示，BMI对LTE4的影响强于可替宁。LTE4浓度与性别、年龄和肺活量无关。可替宁与FEV1（rS=-0.22, p=0.04）和FVC（rS=-0.25, p=0.02）成负相关；若按组分析，这些相关性仅在哮喘患儿中存在显著性。
   结论：环境烟草烟雾暴露（通过尿可替宁评价）与尿液LTE4浓度增加相关，但BMI对LTE4的影响更大。尿可替宁与肺功能下降有关，主要见于哮喘患儿。
 

（苏楠 审校）
J Asthma. 2013 Feb 12. [Epub ahead of print]

 

Passive Smoking Induces Leukotriene Production in Children: Influence of Asthma.
 
Hernández-Alvídrez E, Alba-Reyes G, Muñoz-Cedillo BC, Arreola-Ramírez JL, Furuya ME, Becerril-Ángeles M, Vargas MH.

Source
Departamento de Neumopediatría, Hospital General Gaudencio González Garza, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social , Mexico DF , Mexico.

Abstract 
BACKGROUND：Passive smoking is associated with poor asthma control in children, but the mechanism is unknown. Leukotrienes are involved in the asthma pathogenesis and their synthesis is increased in adult subjects who actively smoke.
OBJECTIVE：To evaluate whether passive smoking, as assessed by urinary cotinine levels, increases leukotriene production in children with or without asthma.
METHODS：This was a prospective, cross-sectional study in which children with stable intermittent asthma (without exacerbation) and healthy control children were studied through spirometry and urinary concentrations of cotinine and leukotriene E(4) (LTE(4)). Both groups were balanced to include children with and without passive smoking.
RESULTS：Ninety children (49 with asthma and 41 controls, 54.4% females) aged 9 years (range, 5-13 years) were studied. Urinary LTE(4) concentrations were progressively higher as cotinine levels increased (rS=0.23, p=0.03). LTE(4) also correlated with body mass index (BMI, rS=0.30, p=0.004), and multiple regression analysis revealed that BMI was even more influential than cotinine for determining LTE(4) levels. LTE(4) concentrations were unrelated with gender, age, or spirometry. In turn, cotinine inversely correlated with FEV(1) (rS=-0.22, p=0.04) and FVC (rS=-0.25, p=0.02), but when analyzed by groups, these relationships were statistically significant only in children with asthma.
CONCLUSIONS： Exposure to environmental tobacco smoke, as assessed by urinary cotinine levels, was associated with an increased urinary concentration of LTE(4), although BMI exerted more influence in determining its concentration. Urinary cotinine was associated with decreased lung function, mainly in children with asthma.

J Asthma. 2013 Feb 12. [Epub ahead of print]