支气管哮喘患儿血Th17细胞变化及槐杞黄颗粒的干预作用

Changes of Th17 Cells in Peripheral Blood of Asthmatic Children and Interventive Effect of Huai Qi Huang Particles

目的观察哮喘患儿Th细胞亚群水平变化及槐杞黄颗粒对婴幼儿哮喘的早期干预作用。方法选取哮喘儿童60例为哮喘组,健康儿童30例为健康对照组。流式细胞术检测2组儿童外周血单个核细胞(PBMC)Th1、Th2及Th17细胞百分率。将哮喘患儿随机分为A组、B组,A组给予糖皮质激素和支气管扩张剂吸入及白三烯拮抗剂口服等常规治疗,B组在常规治疗基础上加用槐杞黄颗粒,疗程为3个月。观察2组患儿疗效。结果 1.哮喘组IFN-γ的CD4+细胞(Th1)水平较健康对照组低,表达IL-4、IL-17的CD4+细胞(Th2、Th17)较健康对照组高,差异均有统计学意义(P=0.006,0.028,0.041)。2.治疗3个月,哮喘组Th1水平有所回升,Th2水平有所下降,A组、B组治疗前后比较差异均有统计学意义(P=0.002,0.001;P=0.017,0.009);Th17水平有所下降,A组治疗前后比较差异无统计学意义(P=0.051),B组治疗前后比较差异有统计学意义(P=0.032)。3.A组、B组Th1、Th2、Th17治疗前和治疗后比较差异均无统计学意义。4.B组治疗总有效率明显优于A组(93.33%vs73.33%;χ2=4.320,P=0.038)。结论 Th17可能参与哮喘的发病。槐杞黄颗粒长期使用可通过逆转哮喘患儿体内Th1和Th2细胞的免疫失衡达到对哮喘的早期干预作用,还可能通过调节Th17细胞,进而影响IL-17介导的中性粒细胞炎症,提高哮喘治愈率。

Objective To observe the levels of Th cell subsets in the asthmatic children and the role of early intervention of Huai Qi Huang particles on asthma in infants and young children.Methods Flowcytometry was used to detect the cells percentages of the Th1,Th2 and Th17 in the peripheral blood of asthma children （asthma group,n= 60） and healthy children （healthy control group,n=30）.Asthma childreh were randomly divided into 2 groups：group A and group B.Group A was given corticosteroids and leukotriene antagonist oral suction;while in group B, Huai Qi Huang particles was added in combination with the conventional therapy, treatment lasted for 3 months in each group, and the therapeutic efficacy was observed.Results 1.Compared with the healthy control group,the number of CD4^＋ cells （Th1） expressing interferon-γ was decreased in the peripheral blood in the asthma group.The numbers of CD4^＋ cells （Th2,Th17） expressing IL-4 and IL-17 were increased.And the differences were statistically significant（P=0.006,0.028,0.041）.2.After treatment for 3 months,in the asthma group, the number of Th1 rebounded and the number of Th2 and Th17 both decreased.In group A,the changes in the number of Th1 and Th2 were statistically significant before and after treatment （P=0.002,0.017）,but the change of Th17 was not statistically significant（P=0.051）.In group B,the changes in the numbers of Th1,Th2 and Th17 were all statistically significant （P=0.001,0.009,0.032）.3.Before and after treatment,the changes of Th1,Th2,Th17 had no statistically significant between the group A and group B.4.The treatment efficiency of group B was significantly higher than that in group A （93.33% vs 73.33%;χ^2=4.320,P=0.038）.Conclusions Th17 might be related to the pathogenesis of asthma,and its mechanism in the pathogenesis of asthma remains to be further studied.The role of early intervention on asthma of long-term using Huai Qi Huang particles was achieved through reversing the immune imbalance of Th1 and Th2 in blood.And it also may be linked to excessive regulation of Th17 cells,which affects IL-17 neutrophil-mediated inflammation and improves the cure rate of asthma.