布地奈德对支气管哮喘儿童血CKLF-1、IL-4和IFN-γ水平的影响

Effect of budesonide on the expression of CKLF-1,IL-4 and IFN-γ in children with bronchial asthma

目的探讨CKLF-1、IL-4和IFN-γ在儿童支气管哮喘发病机制中的作用及布地奈德对其的影响。方法选择25例健康体检儿童为对照组,另分别选择轻、中、重度支气管哮喘儿童25、28、15例作为观察组,检测并比较对照组和各观察组经布地奈德雾化吸入治疗前、后血中CKLF-1、IL-4和IFN-γ的水平。结果治疗前各哮喘患儿组血CKLF-1、IL-4水平均显著高于对照组(P<0.05),中度组血CKLF-1、IL-4水平显著高于轻度组(P<0.05),重度组血CKLF-1、IL-4水平显著高于中度组(P<0.05),而治疗前各哮喘患儿组血IFN-γ水平均显著低于对照组(P<0.05),中度组血IFN-γ水平显著低于轻度组(P<0.05),重度组血IFN-γ水平显著低于中度组(P<0.05);治疗前各哮喘患儿组血CKLF-1、IL-4水平显著高于治疗后(P<0.05),治疗前各哮喘患儿组血IFN-γ水平显著低于治疗后(P<0.05);治疗后轻、中、重度哮喘患儿组和对照组4组间的血CKLF-1、IL-4、IFN-γ水平差异无统计学意义(P>0.05)。结论哮喘儿童存在着严重的免疫失衡,而布地奈德雾化吸入可以较好地纠正这一失衡。CKLF-1、IL-4和IFN-γ在儿童哮喘的发生、发展中起重要作用,在诊断和治疗过程中实施对它们的监测具有十分重要的临床意义。

Objective To investigate the role of CKLF-1, IL-4 and IFN-γ in the pathogenesis of bronchial asthma in chil- dren and assess the effect of Budesonide on the expression of CKLF-1, IL-4 and IFN-γ. Methods Twenty-five children for health examination were enrolled into the study as the control group, and 68 children with bronchial asthma were in- cluded in the experimental group. The experimental group was divided into the mild group （25 patients） , the moderate group（28 patients） and the severe group（ 15 patients） according to the severity of the disease. The levels of CKLF-1 ,IL- 4 and IFN-γ in the blood prior to and after the treatment with inhaled Budesonide were determined and compared among all the groups. Results The levels of CKLF-1 and IL-4 in the blood prior to the treatment with inhaled Budesonide were significantly higher in the mild, moderate and severe groups than those in the control group（ P 〈 0.05 ） , the blood CKLF- 1 and IL-4 levels in the moderate group were significantly higher than those in the mild group（ P 〈0.05 ） ;the blood CK- LF-1 and IL-4 levels in severe group were significantly higher than those in the moderate group （ P 〈 0.05 ）. The blood IFN-γ levels prior to the treatment with inhaled Budesonide were significantly lower in the mild, moderate and severe groups as compared with those in the control group （P 〈 0.05 ） ;the blood IFN-γ levels in the moderate group were signifi- cantly lower than that in the mild group （ P 〈 0.05 ）, the blood IFN-γ levels in the severe group was significantly lower than that in the moderate group （P 〈 0.05 ）. The levels of CKLF-1 and IL-4 in the mild, moderate and severe groups were significantly before the treatment than that after the treatment （ P 〈 0.05 ）. The IFN-γ levels in the mild, moderate and se- vere groups decreased significantly after the treatment（ P 〈0. 05 ） ; The levels of CKLF-1, IL-4 and IFN-γ was not signifi- cantly different among the four groups after the treatment （P 〉 0.05 ）. Conclusion The imbalance of immune system might play an important role in the pathogenesis of asthma in children. Budesonide can regulation this imbalance. CKLF- 1, IL-4 and IFN-γ plays an important role in the development and progression of asthma in children, therefore, monitoring of CKLF-1, IL-4 and IFN--γ level is of great significance in the diagnosis and treatment of asthma.