儿童哮喘支气管肺泡灌洗液成分分析

The Components Analysis of Bronchoalveolar Lavage Fluid of Pediatric Asthma Patients

目的：通过对儿童哮喘支气管肺泡灌洗液成分分析探讨其发病机制。方法：应用酶联免疫吸附实验（ELISA）方法,对哮喘（29例）、支气管肺炎（26例）和对照组（20例）共75例患儿的支气管肺泡灌洗液进行细胞成分分析及上清液IgE、IL-12、IL-4、IL-13浓度测定。结果：哮喘组支气管肺泡灌洗液嗜酸性粒细胞为3.3%（1.0%~9.0%）,上皮细胞2.9%（0.5%~9.8%）,IgE为（98.76±15.65）ng/L,IL-4为（17.89±3.65）ng/L,IL-13为（6.75±0.87）ng/L,与支气管肺炎组和对照组相比明显增高,差异有非常显著意义（P〈0.01）;哮喘组IL-12为（2.12±0.76）ng/L,与支气管肺炎组和对照组相比明显降低,差异有非常显著意义（P〈0.01）;支气管肺炎组中性粒细胞明显增多。结论：哮喘患儿支气管肺泡灌洗液以嗜酸性粒细胞和上皮细胞增多及IgE增高为其特征;哮喘患儿支气管肺泡灌洗液IL-4、IL-13浓度增高,IL-12浓度降低,提示Th1/Th2失衡是哮喘重要发病机制;支气管肺泡灌洗液检查可为哮喘患儿诊断提供有益线索。

Objective： To explore the pathogenesis of pediatric asthma, we analyzed the pediatric asthma bronchoalveo- lar [avage fluid including cell composition and cytokine level. Methods.. Using ELISA, we measured IgE, IL-12, IL-4 and II.-13 and counting the cell number in bronchoalveolar lavage fluid of 75 patients including asthma（n= 29）, broncho- pneumonia （n=26）, control （n=20）. Results.. In the group of asthma, eosnophils was 3.3%（1.0 %-49. 0%） ,epitheli- al cell 2.9%（0.5%-9. 8%）,IgE was （98. 76±15.65）ng/L,IL-4 was （17.89±3.65）ng/L, IL-13 was （6.75±0. 87） ng/L. That was significantly higher than the group of bronchopneumonia and control（P〈0. 01 ）. IL-12 （2. 12 ±0.76） ng/L in the group of asthma was significantly lower than the group of bronchopneumonia and control（P（0. 01）. How- ever, neutrophil was obviously increased in the bronchopneumonia. Conclusion：Pediatric asthma bronchoalveolar lavage fluid was characterized with the increase of eosnophils, epithelial cell and IgE. The concentration of IL-4 and IL-13 in- creased, but the concentration of IL-12 decreased in the bronchoalveolar lavage fluid of pediatric asthma. It is sugges- ted that the unbalance of Th1/Th2 is of importance in the pathogenesis of pediatric asthma.