小儿哮喘及肺炎血浆白介素-18、-16、-4及IFN-γ水平的相关性研究及临床意义

Correlations of plasma IL-18,IL-16,IL-4,IFN-γ levels with asthma or pneumonia and clinical significance in children

目的探讨哮喘及肺炎患儿血浆白介素-18、-16、-4及IFNγ-水平的相关性及临床意义。方法哮喘患儿22例,肺炎患儿24例(重症组13例,普通组11例)。采用双抗体夹心酶联免疫吸附实验(SELISA)测定其血浆IL-18、IL-16、IL-4、IFNγ-水平。结果(1)哮喘组急性期血浆中IL-16低于非发作期(P<0.05)及对照组(P<0.01),非发作期高于对照组(P<0.01)。非发作期IL-4低于急性期及对照组(P<0.05)。血浆IL-18、IFNγ-无明显改变。急性期IL-18、IL-16、IL-4、IFNγ-水平存在相关性(P<0.01),IL-4与IFNγ-存在相关性(P<0.05)。(2)肺炎组急性期IL-18显著升高,重症组IL-18显著高于普通组(P<0.05)。重症组IL-16显著高于对照组(P<0.05)。各组间IL-4及IFNγ-无统计学差异(P>0.05)。急性期IL-18与IL-16、IL-4、IFNγ-之间存在高度相关性(P<0.01)。IL-16与IFNγ-存在相关性(P<0.05)。结论IL-18、IL-16、IL-4、IFNγ-参与了小儿哮喘和肺炎免疫病理过程。

Objective To investigate relationships between plasma levels of IL-18, IL-16, IL-4 and IFN-γ in patients with asthma or pneumonia and clinical significance in children. Methods A total of 22 cases of asthma, 24 cases pneumonia （13 severe, 11 mild） were recruited into the study, and 20 healthy children as control. IL-18, IL-16, IL-4 and IFN-γ levels were measured by Sandwich ELISA. Results 1. The plasma levels of IL-16 were significantly decreased in patients with asthma at the acute period compared with the convalescent period （P 〈 0.05） and controls （ P 〈 0.01 ） ; but significantly increased at convalescent period compared with control （ P 〈 0.01）. The plasma levels of IL-4 were significantly decreased in patients with asthma at the convalescent period compared with the acute （ P 〈 0.05） period and control （ P 〈 0.05）. The plasma levels of IL-18 or IFN-γ had no significant differences between the patient and control groups. At acute period of child patients with asthma, there were correlations with plasma levels of IL-18, IL-16, IL-4 and IFN-γ. 2. The plasma levels of IL-18 were significantly elevated in the child patients with pneumonia at acute period compared with the control （P 〈 0.05）, and were significantly elevated in the child patients with severe pneumonia at acute period compared with the mild pneumonia （ P 〈 0.05） and the control （ P 〈 0.01）. The plasma levels of IL-16 were significantly elevated in patients with severe pneumonia at acute period compared among the control （P 〈 0.05）. The plasma levels of IL-4 or IFN-γ had no significant changes in patients with pneu- monia at acute period compared with control. At acute period of pneumonia, there were correlations among the plasma levels of IL-18 and IL-4, IL-16, IFN-γ, and between the plasma leveLs of IL-16 and IFN-γ. Conclusion The plasma levels of IL-16 were significantly decreased and IL-4 were significantly increased in the child patients with asthma at the acute period. However, at the convalescent period of the asthma, plasma IL-16 was increased. There is an imbalanced Th1 and Th2 cytokine profiles in child asthma. The IL-18, IL-16 levels were significantly elevated in child patients with pneumonia, and the expression of elevated cytokines may reflect severity of disease.