儿童细菌性肺部感染支气管肺泡灌洗液中β-葡糖苷酸酶活性的增加：一项病例对照研究。

Increased β-glucuronidase activity in bronchoalveolar lavage fluid of children with bacterial lung infection: A case-control study.

机构信息

Respiratory Unit, Department of Paediatrics, University General Hospital of Patras, Rion-Patras, Greece.

Paediatric Pulmonology and Allergy Research Group, University of Patras, Rion-Patras, Greece.

出版信息

Respirology. 2015 Nov;20(8):1248-54. doi: 10.1111/resp.12596. Epub 2015 Jul 14.

DOI:10.1111/resp.12596

PMID:26172956

Abstract

BACKGROUND AND OBJECTIVE

β-Glucuronidase is a lysosomal enzyme released into the extracellular fluid during inflammation. Increased β-glucuronidase activity in the cerebrospinal and peritoneal fluid has been shown to be a useful marker of bacterial inflammation. We explored the role of β-glucuronidase in the detection of bacterial infection in bronchoalveolar lavage fluid (BALF) of paediatric patients.

METHODS

In this case-control study, % polymorphonuclear cell count (PMN%), β-glucuronidase activity, interleukin-8 (IL-8), tumour necrosis factor-α (TNF-α) and elastase were measured in culture-positive (≥10(4) cfu/mL, C+) and -negative (C-) BALF samples obtained from children.

RESULTS

A total of 92 BALF samples were analysed. The median β-glucuronidase activity (measured in nanomoles of 4-methylumbelliferone (4-MU)/mL BALF/h) was 246.4 in C+ (interquartile range: 71.2-751) and 21.9 in C- (4.0-40.8) (P < 0.001). The levels of TNF-α and IL-8 were increased in C+ as compared with C- (5.4 (1.7-12.6) vs 0.7 (0.2-6.2) pg/mL, P < 0.001 and 288 (76-4300) vs 287 (89-1566) pg/mL, P = 0.042, respectively). Elastase level and PMN% did not differ significantly (50 (21-149) vs 26 (15-59) ng/mL, P = 0.051 and 20 (9-40) vs 18 (9-34) %, P = 0.674, respectively). The area under the curve of β-glucuronidase activity (0.856, 95% confidence interval (CI): 0.767-0.920) was higher than that of TNF-α (0.718; 95% CI: 0.614-0.806; P = 0.040), IL-8 (0.623; 95% CI: 0.516-0.722; P = 0.001), elastase (0.645; 95% CI: 0.514-0.761; P = 0.008) and PMN% (0.526; 95 % CI: 0.418-0.632; P < 0.001).

CONCLUSIONS

This study demonstrates a significant increase of β-glucuronidase activity in BALF of children with culture-positive bacterial inflammation. In our population β-glucuronidase activity showed superior predictive ability for bacterial lung infection than other markers of inflammation.

摘要

背景与目的

β-葡糖苷酸酶是一种溶酶体酶，在炎症期间释放到细胞外液中。已经证明，脑脊液和腹腔液中β-葡糖苷酸酶活性的增加是细菌炎症的有用标志物。我们探讨了β-葡糖苷酸酶在检测儿科患者支气管肺泡灌洗液（BALF）中细菌感染中的作用。

方法

在这项病例对照研究中，我们测量了培养阳性（≥10（4）cfu/mL，C+）和阴性（C-）BALF 样本中多形核细胞计数（PMN%）、β-葡糖苷酸酶活性、白细胞介素-8（IL-8）、肿瘤坏死因子-α（TNF-α）和弹性蛋白酶。

结果

共分析了 92 份 BALF 样本。C+组（BALF/h）β-葡糖苷酸酶活性的中位数为 246.4（四分位距：71.2-751），C-组为 21.9（4.0-40.8）（P<0.001）。与 C-相比，C+中 TNF-α和 IL-8 的水平升高（5.4（1.7-12.6）比 0.7（0.2-6.2）pg/mL，P<0.001 和 288（76-4300）比 287（89-1566）pg/mL，P=0.042）。弹性蛋白酶水平和PMN%无显著差异（50（21-149）比 26（15-59）ng/mL，P=0.051 和 20（9-40）比 18（9-34）%，P=0.674）。β-葡糖苷酸酶活性的曲线下面积（0.856，95%置信区间（CI）：0.767-0.920）高于 TNF-α（0.718；95%CI：0.614-0.806；P=0.040）、IL-8（0.623；95%CI：0.516-0.722；P=0.001）、弹性蛋白酶（0.645；95%CI：0.514-0.761；P=0.008）和PMN%（0.526；95%CI：0.418-0.632；P<0.001）。