小儿哮喘患者花剥苔与免疫的关系及血细胞变化

Relationship Between Exfoliative Tongue Fur and Immunity and Change of the Blood Cell in Children with Asthma

目的:采用免疫组织化学、细胞化学的方法,检测小儿哮喘花剥苔及对照组小儿血清免疫指标和血液细胞指标,以探讨小儿哮喘患者花剥苔形成的免疫机制。方法:采用临床流行病学方法,共调查562人,收回登记表352份。依据病例的诊断标准,根据哮喘以及花剥苔的有无分为哮喘花剥苔组、哮喘非花剥苔组和非哮喘花剥苔组,分三次分别检测其血清IgE、血清中CD4、CD8、CD28的含量。结果:在哮喘患儿中,花剥苔的发生率占33%。在花剥苔患儿中,哮喘的发生率占48%。IgE:哮喘花剥苔组明显高于正常人对照组,P<0.05;哮喘花剥苔组低于哮喘非花剥苔组,P<0.05;哮喘花剥苔组明显高于非哮喘花剥苔组,P<0.05;哮喘非花剥苔组小于非哮喘花剥苔组,P<0.05;哮喘非花剥苔组高于正常人对照组。以上各组比较均有显著性差异。CD4:哮喘花剥苔组小于非哮喘花剥苔组,更小于正常人对照组,均P<0.05,均有显著性差异。CD8:哮喘非花剥苔组高于正常人对照组,P<0.05,有显著性差异。CD28:哮喘花剥苔组、哮喘非花剥苔组和非哮喘花剥苔组都高于正常人对照组,P<0.05,有显著性差异。RBC:哮喘花剥苔组明显低于正常人对照组,P<0.05;哮喘非花剥苔组明显低于正常人对照组,P<0.05;非哮喘花剥苔组明显低于正常人对照组,P<0.05。结论:小儿花剥苔的出现可以为追踪小儿哮喘找到线索,其病理本质和小儿免疫力低下有一定联系,如IgE、CD8、CD28水平异常升高,CD4水平降低,血中红细胞数异常等,都可以作为中医治疗小儿哮喘的观察指标之一。

Objective：The methods of immunohistochemistry and cytochemistry were chosen to detect exfoliative tongue fur of children,child immune index of the blood serum and blood cell index in control group,thus to probe the immune mechanism formed by exfoliative tongue fur of children.Methods：The clinical epidemiological methods were taken to investigate 562 patients,and 352 registration forms were got.According to the diagnostic standard of cases and whether to have asthma and exfoliative tongue fur or not,the patients were divided into the group with asthma and exfoliative tongue fur,the group with asthma and no exfoliative tongue fur and the group without asthma and exfoliative tongue fur.The contents of serum IgE,CD4,CD8 and CD28 of the serum were respectively detected 3 times.Results：In the child patients with asthma,the occurring rate of exfoliative tongue fur was 33%.In the child patients with exfoliative tongue fur,the occurring rate of asthma was 48%.As to IgE,there existed significant differences among four groups：the group with asthma and exfoliative tongue fur,normal control group,the group with asthma and no exfoliative tongue fur,the group without asthma and exfoliative tongue fur.CD4 of the group with asthma and exfoliative tongue fur was lower than that of the group without asthma and no exfoliative tongue fur（P〈0.05）,There existed significant differences.CD8 of the group without asthma and exfoliative tongue fur was apparently higher than that of normal control group（P〈0.05）.There existed significant differences.CD28 of the group with asthma and exfoliative tongue fur,the group with asthma and no exfoliative tongue fur and the group without asthma and exfoliative tongue fur were higher than that of normal control group（P〈0.05）.it had significant differences.RBC of the three groups was lower than that of normal control group（P〈0.05）.Conclusion：The appearence of child exfoliative tongue fur can make us find the clue of child asthma.The pathological nature is certain related with the lower immune ability of children.The abnormal increase of IgE,CD8 and CD28,the decrease of CD4 and the abnormal blood cell can be used as the observing index of child asthma treated by TCM.