毛细支气管炎患儿血清MCP-4、MDC和IL-4水平及临床意义

Clinical significance of MCP-4,MDC and IL-4 in infants with acute bronchiolitis

目的研究毛细支气管炎患儿外周血中单核细胞趋化蛋白4(MCP-4)、巨噬细胞衍生趋化因子(MDC)和白介素4(IL-4)水平的变化,探讨其临床意义。方法采用酶联免疫吸附法(ELISA)分别测定31例毛细支气管炎患儿(毛支组)和30例健康儿童(正常对照组)血清MCP-4、MDC和IL-4水平,并进行比较。结果毛支组患儿急性期血清MCP-4、MDC和IL-4水平为(103.56±27.31,692.67±107.22,19.48±7.40)pg/ml,明显高于正常对照组(86.34±14.50,242.12±27.40,9.22±4.10)pg/ml(P均<0.01)。MCP-4、IL-4的升高程度与病情严重程度相关,且两者之间呈正相关。结论MCP-4、MDC参与调节毛细支气管炎Th2细胞因子IL-4的募集、释放,参与毛细支气管炎的发病;监测血清MCP-4水平可反映毛细支气管炎的病情严重程度,具有重要的临床价值。

Objectives To investigate the clinical value of monocyte chemoattractant protein-4 （MCP-4）, macrophage-derived chemokine （MDC） and interleukin-4 （IL-4） in serum of infants with acute bronchiolitis. Methods Serum samples were obtained from 31 children with acute bronchiolitis and 30 healthy children. Eighteen males and thirteen females with mean age of 6.8 months were included in bronchiolitis group. According to patients＇ clinical symptoms, 31 samples were divided into mild bronchiolitis group and severe bronchiolitis group, respectively; no patients took any glucocorticoid during two weeks before hospital admission. Control group included 16 males and 14 females with mean age of 7.5 months. ELISA was used to determine the concentrations of MCP-4, MDC and IL-4 in serum. Results The serum levels of MCP-4, MDC and IL-4 in patients with bronchiolitis during acute stage were much higher than those in control group. Statistically significant difference was found between the two groups, with MCP-4 （103.56 ± 27.31 vs. 86.34 ± 14.50）pg/ml, MDC （692.67 ± 107.22 vs. 242.12 ± 27.40 ） pg/ml and IL-4 （19.48 ± 7.40 vs. 9.22 ± 4.10） pg/ml （all P 〈 0.01）. The serum levels of MCP-4 and MDC correlated well to that of IL-4. Moreover, in the bronchiolitis group, the serum level of MCP-4 correlated well with the severity of clinical symptoms. The MCP-4 level in severe group was （117.94 ± 24.96）pg/ml, which was markedly higher than that of mild group （93.17 ± 24.57） pg/ml （t = 2.75, P 〈 0.05） . Conclusions MCP-4 and MDC are two important ehemokines involved in the pathogenesis of acute bronchiolitis, the increased level of MCP-4 is an objective target indicating the severity of the acute bronchiolitis.