集群免疫治疗对支气管哮喘患者血清IL-4和INF-γ的影响

Effect of cluster immunotherapy on serum IL-4 and INF-γ in patients with bronchial asthma

目的检测集群免疫治疗(cluster immunotherapy)前后轻中度支气管哮喘患者血清白细胞介素4(IL-4)和γ干扰素(INF-γ)的变化,探讨集群免疫治疗的机制。方法 68例轻中度过敏性哮喘患者,随机分为治疗组和对照组各34例,对照组给予抗组胺药物、布地奈德气雾剂和沙丁胺醇气雾剂治疗;治疗组在应用上述药物的同时给予剂量累加阶段为期7周的集群免疫治疗,而后每4周给予1次维持治疗。两组疗程均为1年,在治疗前后分别采用酶联免疫吸附试验(ELISA)方法检测患者血清IL-4和INF-γ值。检测数据应用SPSS15.0统计学软件进行分析。结果两组中所有患者均完成了为期1年的治疗。治疗后两组患者血清IL-4值降低,而血清INF-γ值升高。治疗组血清IL-4值(均数±标准差)由治疗前的(17.01±3.26)ng/L降至(11.43±2.48)ng/L,而对照组由治疗前的(16.84±2.94)ng/L降至(13.89±3.05)ng/L,治疗组血清IL-4值明显低于对照组,两组比较差异有显著统计学意义(P<0.01);治疗组血清INF-γ值(均数±标准差)由治疗前的(12.24±2.39)ng/L增至(16.98±3.16)ng/L,而对照组由治疗前的(11.96±2.15)ng/L增至(13.92±2.34)ng/L,治疗组血清INF-γ值明显高于对照组,两组比较差异有显著统计学意义(P<0.01)。结论集群免疫治疗能有效降低患者血清IL-4值,同时能升高INF-γ值。本研究表明调节患者血清IL-4和INF-γ的平衡可能是集群免疫治疗的分子免疫机制之一。

Objective To measure the changes of serum interleukin-4 （IL-4） and interfemn-γ （INF-γ） values in patients with mild to moderate bronchial asthma before and after cluster immunotherapy and explore the pathogenesis of cluster immunotherapy. Methods 68 patients with mild to moderate allergic asthma were divided randomly into treatment group and control group with 34 patients each. Patients in control group were treated with antihistamine, budesonide aerosol, salbutamol aerosol while patients in treatment group were treated with antihistamine, budesonide aerosol, salbutamol aerosol and received specific immunotherapy in s 7-week cluster schedule during the incremental-dose phase. Thereafter, patients in treatment group received maintenance-dose in- jection at 4-week intervals until the end of one-year of treatment. The treatment course of control group is one-year too. The IL-4 and INF-γ values were measured with enzyme linked immunosorbent assay （ELISA） technique at the baseline and after 1 year treat- mont. The data were analyzed by statistical software SPSS15. O. Results All patients in two groups were completed the one-year treatment. The IL-4 values in serum of patients in two groups reduced hut the INF-γvalues increased. The IL-4 values（x±s）in serum of patients in treatment group reduced from （17.01±3.26 ）ng/L to （11.43±2.48 ）ng/L, while those in control group reducod from （ 16.84±2.94 ） ng/L to （ 13.89± 3.05 ） ng/L. Comparing with patients in control group, the IL-4 values in serum were significantly lower, the difference had statistical significance （P 〈0.01 ）. The INF-γvalues（x±s） in serum of patients in treatment group increased from （ 12.24±2.39） ng/L to （ 16. 98± 3.16） ng/L, while those in control group reduced from （ 11.96±2.15 ） ng/L to （ 13.92± 2.34 ） ng/L. Comparing with patients in control group, the INF-γ values in serum were significantly higher, the difference had statistical significance （P 〈 0.01 ）. Conclusion Cluster immunotherapy can reduce the IL-4 value in serum affectedly, while it can increase the INF-γ value in senun affectedly. It serum that affectedly. the balance of IL-4 and INF-γ values in serum should he one of the immunolosie mechanisms of duster immunotherapy.