摘要
目的检测难治性肺炎支原体肺炎(RMPP)患儿支气管肺泡灌洗液(BALF)中IL-4、INF-γ水平,探讨RMPP患儿病变局部Th1、Th2型细胞因子水平的变化及其意义。方法选择RMPP患儿(42例)为研究对象。根据是否有湿疹、过敏性鼻炎、荨麻疹及相关过敏性疾病家族史等将42例RMPP患儿分为特应性组(11例)和非特应性组(31例)。以同期因支气管异物住院、异物取出4周后纤维支气管镜复查的患儿为对照组(12例)。对RMPP患儿及对照患儿BALF中细胞学成分进行分析,并采用ELISA方法检测BALF中IL-4、INF-γ水平。结果与对照组比较,RMPP组患儿BALF中细胞总数上升(P<0.05),其中以中性粒细胞上升为主(P<0.01);RMPP组患儿BALF中INF-γ、IL-4均显著升高(P<0.05)。与对照组比较,特应性组BALF中INF-γ、IL-4均显著升高(P<0.05),非特应性组INF-γ显著升高(P<0.05)。各组间INF-γ/IL-4比值差异均无统计学意义(P>0.05)。结论 RMPP患儿BALF细胞数显著增加,尤以中性粒细胞为甚。RMPP患儿BALF中INF-γ、IL-4水平明显升高,但INF-γ/IL-4比值无变化,提示RMPP患儿病变局部炎症反应明显,但尚不能证实RMPP患儿存在Th2占主导的炎症反应。
Objective To measure levels of interleukin-4 (IL-4) and interferon-gamma (INF-γ) in the bronchoalveolar lavage fluid (BALF) of children with refractory Mycoplasma pneumoniae pneumonia ( RMPP), and to investigate changes in local Thl-Th2-type cytokine levels in children with RMPP and their significance. Methods A total of 42 children with RMPP were divided into atopic ( n = 11 ) and non-atopic groups ( n = 31 ) according to whether they had eczema, allergic rhinitis, urticaria, and family history of allergic disease. The study also included a control group of 12 children with bronchial foreign bodies who underwent foreign body removal and were re-examined by fiberoptic bronchoscopy four weeks later. The different cells in BALF from all children were analyzed, and the levels of IL-4 and INF- ",/in BALF were measured using enzyme-linked immunosorbent assay. Results Compared with the control group, the total number of cells in BALF from children with RMPP increased significantly (P 〈 0.05), the increase mainly accounted for by neutrophils (P 〈 0. 01 ), and levels of IL-4 and INF-γ in BALF from children with RMPP increased significantly ( P 〈 0.05 ). Compared with the control group, levels of IL-4 and INF--γin BALF in the atopic group increased significantly (P 〈 0.05). The level of INF-3, in BALF in the non-atopic group also increased significantly (P 〈 0.05). There were no significant differences in INF-γ/IL-4 ratio among all groups ( P 〉 0. 05 ). Conclusions Significant increase in cell numbers, especially neutrophils, as well as IL4 and INF-γ levels, can be seen in BALF from children with RMPP, but there is no change to the INF-γ/IL-4 ratio. This indicates a significant local inflammatory response in children with RMPP, but there is no evidence of Th2-dominated inflammatory response.
出处
《中国当代儿科杂志》
CAS
CSCD
北大核心
2012年第8期581-584,共4页
Chinese Journal of Contemporary Pediatrics