老年支气管哮喘患者血清25-(OH)VD_3与免疫功能改变的相关性研究

Clinical research on the relationship between the changement of immune function and the level of serum 25-(OH) VD_3 in elderly patients with bronchial asthma

目的探讨老年支气管哮喘患者血清25-羟基维生素D_3[25-(OH)VD_3]与免疫功能改变的相关性。方法选取104例老年支气管哮喘患者作为研究对象,其中哮喘急性发作组52例,哮喘缓解组52例,对照组为同期的52例健康体检者。应用酶联免疫吸附法测定血清25-(OH)VD_3的水平,采用免疫比浊法检测血清免疫蛋白指标:IgA、IgG和IgM。采用流式细胞仪测定CD4^+、CD8^+和CD4^+/CD8^+T淋巴细胞水平。比较哮喘患者和对照组的血清25-(OH)VD_3水平的变化,各免疫指标的变化。分析25-(OH)VD_3与各免疫指标的相关性。结果哮喘急性发作组和哮喘缓解组患者血清25-(OH)VD_3均显著低于对照组,进行组间比较,哮喘急性发作组的血清25-(OH)VD_3水平显著低于哮喘缓解组,差异均有统计学意义(P<0.05)。哮喘患者的CD4^+和CD4^+/CD8^+水平均显著低于对照组(P<0.05),其CD8^+水平显著高于对照组(P<0.05),哮喘患者的IgA,IgG和IgM水平均显著低于对照组(P<0.05)。血清25-(OH)VD_3与CD4^+,CD4^+/CD8^+,IgA,IgG呈显著正相关性,与CD8^+呈显著负相关性。结论老年支气管哮喘患者的血清25-(OH)VD_3显著降低,且与患者的免疫功能密切相关。

Objective To discuss the relationship between the changement of immune function and the level of serum 25-（ OH） VD_3 in elderly patients with bronchial asthma. Methods One hundred and four elderly patients with asthma were selected as the research subjects,and divided into asthma acute attack group（ 52 cases） and asthma remission group（ 52 cases）. Another 52 healthy subjects were selected as the control group. Enzyme linked immunosorbent assay（ ELISA） was used to detect the content of 25-（ OH） VD_3. The index of immunoglobulin： Ig A,Ig G and Ig M were detected by immune turbidity method. The levels of CD4~＋,CD8~＋and CD4~＋/ CD8~＋lymphocytes were measured by flow cytometry. The changes of 25-（ OH） VD_3 and immune indexes in asthma patients and control group were compared. The correlation between 25-（ OH） VD_3 and the immune indexes were analyzed. Results The levels of 25-（ OH） VD_3 of patients in asthma acute attack group and asthma remission group were significantly lower than those in the control group,and the asthma acute attack group was significantly lower than the asthma remission group,the difference was statistically significant（ P〈 0. 05）. The levels of CD4~＋and CD4~＋/ CD8~＋in asthma patients were significantly lower than those in the control group（ P 〈0. 05）,whose CD8~＋levels were significantly higher than those in the control group（ P〈 0. 05）,and the levels of Ig M,Ig G and Ig A in asthma patients were significantly lower than those in the control group（ P〈 0. 05）. The correlation analysis showed that the expression levels of CD4~＋,CD4~＋/ CD8~＋,Ig A,Ig G in asthma patients were positively correlated with 25-（ OH） VD_3（ P〈 0. 01）,and the expression levels of CD8~＋was negatively correlated with 25-（ OH） VD_3（ P 〈0. 01）.Conclusion The serum VD_3（ OH） 25- was significantly decreased in elderly patients with bronchial asthma,and it was closely related to the immune function of the patients.