| Objective: Bronchial asthma(be called for short sathma) is one of the mostcommon chronic respiratory tract disease in childhood.Asthma is a chronicphlogosis disease which is comprise of various cells and constituents.Thischronic disease leads to airway hyperresponsiveness and widely variedreversible airflow limiton, causes recurrent episodes of wheezing, shortnessof breath, chest tightness or symptoms such as cough, and at night and (or)early onset or exacerbation, continuously can produce persistent state ofasthma and endanger life, serious impact on children ’s physical and mentalhealth. Asthma pathogenesis is very complex, and the immune, nervous,endocrine factors and genetics of spirit, closely related to the background. Themain pathophysiological mechanism is on airway inflammation and airwayremodeling. While the airway remodeling of asthmatic children ’s long-termprognosis plays a more important role. Matrix Metalloproteinase-9（MMP-9）and Tissue inhibitor of metalloproteinase-1(TIMP-1)unbalance is theimportant theory of asthmatic airway remodeling, angiogenesis in patientswith asthma airway remodeling is the prerequisite, and Vascular endothelialgrowth factor(VEGF) is the most important positive regulation ofangiogenesis factor. This research through the monitoring of MMP-9, TIMP-1and VEGF in patients with asthma in different periods of dynamic change,discuss its in bronchial asthma pathogenesis mechanism and the role ofclinical diagnosis and treatment, to provide a new theoretical basis andlaboratory evidence, evaluation of therapeutic effect of bronchial asthma, andto open up new therapeutic avenues.Methods:2011February-2012January randomly selected from HebeiMedical University second hospital and Cangzhou People’s Hospital outpatient pediatric wards and in children with bronchial asthma63cases asthe research object, according to the history and clinical performance isdivided into acute exacerbation of asthma and clinical remission of two groups,all of the subjects were consistent with the diagnosis standard of Chinesemedical association pediatric subspecialty group of respiratory diseases in2008to develop the" children bronchial asthma diagnosis and PreventionGuide" on children bronchial asthma diagnostic criteria, and elimination ofnearly a month of oral or intravenous use of corticosteroids or immunemodulators, the first episodes of wheeze and asthma associated with otherautoimmune diseases such as juvenile rheumatoid arthritis, tuberculosis,systemic lupus erythematosus, children. Among them38cases acute attackasthma, clinical remission in25cases. Another randomly selected at the sametime period the same age group and25healthy children as control, the controlgroup children were not allergic disease and immune related disease historyand family history, recent (within1months) no systemic infection, no use ofantibiotics and corticosteroids, antihistamine drugs. Among the groups ingender, age had no significant difference (P>0.05). Using enzymeimmunoassay with double antibody sandwich (ELISA) method for thedetermination of components in serum of children MMP-9, TIMP-1andVEGF levels. The data were analyzed statistically by SPSS13.0software.Statistical method by using variance analysis, linear regression and correlationanalysis, P <0.05for significant boundaries.Result:1serum MMP-9levels (ng/ml): acute attack period group was516.18±186.81; clinical remission was251.95±58.67; normal control group is79.29±26.09. Between the three groups had significant difference (P <0.05). Acute exacerbation and clinical remission was higher than that of thecontrol group, there were statistically significant (P <0.05); acute attackperiod group was higher than that of clinical remission group, there werestatistically significant (P <0.05).2serum TIMP-1levels (ng/ml): acute attack period group was139.04± 49.91; clinical remission was97.64±36.54; normal control group is78.10±32.11. Between the three groups had significant difference (P <0.05).Acute onset period than clinical remission and normal control, with statisticalsignificance (P <0.05); clinical remission with normal control of nostatistical significance (P>0.05).3serum VEGF levels (PG/ml): acute attack period group was341.73±19.32; clinical remission was141.80±18.66; normal control group is41.12±13.96. Between the three groups had significant difference (P <0.05).Acute exacerbation and clinical remission was higher than that of the controlgroup, there were statistically significant (P <0.05); acute exacerbationperiod than clinical remission, with statistical significance (P <0.05).4serum MMP-9/TIMP-1: acute attack period group:3.74±0.28;remission group:2.85±1.04; normal control group:1.07±0.16.Between the three groups had significant difference (P <0.05). Acuteexacerbation and clinical remission was higher than that of the control, therewere statistically significant (P <0.05); acute exacerbation period thanclinical remission, with statistical significance (P <0.05).5Children with asthma serum in acute stage of attack between VEGF andMMP-9showed a positive linear relation, correlation coefficient r=0.358(P<0.05), the linear regression equation was Y=322.59+0.037X.Conclusion:1Children with asthma serum VEGF levels increased, involved in airwayremodeling in asthma.2Serum VEGF levels in children in remission period was lower than duringepisodes of children, the positive effective treatment can reduce the airwayremodeling.3Children with asthma serum MMP-9and TIMP-1levels increased, involvedin the process of airway remodeling. |
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