咳嗽变异型哮喘患者血清总IgE及白细胞介素-4、γ-肿瘤坏死因子的水平变化研究

Level changes of serum total IgE, IL - 4 and TNF - γ in patients with cough variant asthma

目的探讨外周血中血清总IgE及白细胞介素-4（IL-4）、γ-肿瘤坏死因子（TNF-γ）在咳嗽变异型哮喘（CAV）患者发病过程中的相关性。方法研究对象分3组，各20例，分别为单纯CAV患者、CAV合并过敏疾病组和正常成人对照组。采用放射免疫技术、ELISA方法分别测定各组血清总IgE、IL-4、TNF-γ水平。结果单纯CAV患者血清总IgE水平明显高于正常对照组[（160．9±16．7）U／ml，（71．2±13．2）U／ml]，CAV合并过敏性疾病组患者的血清总IgE水平明显高于单纯CAV患者，分别为（371．3±18．5）U／ml和（160．9±16．7）U／ml。单纯CAV患者血清IL-4水平明显高于正常对照组[（26．4±4．6）pg／ml，（17．3±5．1）pg／ml]，CAV合并过敏性疾病组患者的血清总IL-4水平明显高于单纯CAV患者，分别为（35．7±6．9）pg／ml，（26．4±4．6）pg／ml。单纯CAV患者血清TNF-γ水平明显低于正常对照组[（46．3±2．5）pg／ml，（55．3±3．2）pg／ml]，CAV合并过敏性疾病组患者的血清总TNF一1水平明显低于单纯CAV患者，分别为（28．64-2．6）pg／ml和（46．3±2．5）pg／ml。结论CAV患者同支气管哮喘患者一样，存在着Th1／Th2淋巴细胞亚群失衡，变应性鼻炎等过敏性疾病是诱发、加重CAV的重要原因。

Objective To investigate the interrelationship of the peripheral blood serum lever of total IgE, IL -4 and TNF -γ in patients with cough variant asthma（CAV）. Methods The patients with cough variant asthma were divided into three groups, the simple CAV group, the CAV combined allergic diseases group and the normal control group. Each group had 20 cases. Each group were measured the serum lever of total IgE, IL - 4, TNF - γ by radioimmunoassay techniques and ELISA method. Results The serum levels of total IgE were significantly higher in the simple CAV group than in the normal control group [ （160.9 ± 16.7 ）U/ml vs （71.2 ± 13.2）U/ml ]. The serum total levels of IgE were also significantly higher in the CAV combined allergic diseases group than in the simple CAV group [ （ 371.3 ± 18.5 ） U/ml vs （ 160.9 ± 16. 7 ） U/ml ]. The levels of IL - 4 were significantly higher in the simple CAV group than in the normal control group [ （26.4 ± 4.6 ） pg/ml vs （ 17.3 ± 5.1 ） pg/ml ], also significantly higher in the CAV combined allergic diseases group than in the simple CAV group [ （35.7 ± 6.9） pg/ml vs （ 17.3 ± 5.1 ） pg/ml ]. The levels of TNF - γ were significantly lower in the simple CAV group than in the normal control group [ （46.3 ± 2.5 ） pg/ml vs （ 55.3 ± 3.2） pg/ml ], also significantly lower in the CAV combined allergic diseases group than in the simple CAV group [ （ 28.6 ± 2.6 ） pg/ml vs （46. 3 ±2.5）pg/ml]. Conclusions There is a imbalance of lymphocyte subsets Th1/Th2 in patients with CAV as patients with bronchial asthma. It is an important reason for increasing the CAV by allergic rhinitis and other allergic diseases.