儿童高IgE血症患者相关免疫功能指标的探讨

Study on the Immune Function Related Indexes of Children with Hyper Blood IgE

目的探讨儿童高IgE血症患者外周血中补体C3,C4,干扰素γ(interferon-γ,IFN-γ),白细胞介素-4(interleukin-4,IL-4)和CD4^+,CD8^+T淋巴细胞百分比各检测指标与其免疫功能的相关性。方法选取2017年2月~2018年1月福州儿童医院门诊就诊的96例高IgE血症儿童作为研究对象(高IgE组),另外选取同期在医院健康体检的82例儿童作为对照(对照组)。比较两组儿童外周血补体(C3,C4),IFN-γ,IL-4,CD4^+及CD8^+T细胞百分比各指标值,分别计算IFN-γ/IL-4,CD4^+/CD8^+比值。另比较了高IgE组中三种过敏性疾病间的相关性。结果补体C3,C4(g/L),IFN-γ(ng/L),CD4^+T细胞(%)各指标值对比结果:高IgE组(1.07±0.21,0.24±0.06,19.69±2.97,31.07±4.11)显著低于对照组(1.31±0.06,0.35±0.07,25.12±5.05,35.21±6.47)(t=9.94,11.24,8.90,5.17,均P<0.01)。IL-4(ng/L),CD8^+T细胞(%)两指标值对比结果:高IgE组(45.58±8.79,36.96±5.44)显著高于对照组(4.74±1.15,31.93±4.50)(t=41.75,6.66,均P<0.01)。且IFN-γ/IL-4及CD4^+/CD8^+比值高IgE组(0.45±0.10,0.86±0.19)与对照组(5.57±1.61,1.12±0.25)比较明显下降(t=31.15,7.78,均P<0.01),差异均有统计学显著性意义。高IgE组三种过敏性疾病间差异无统计学意义(P>0.05)。结论高IgE血症儿童外周血中IL-4显著升高,IFN-γ及IFN-γ/IL-4明显降低;CD4^+T细胞下降,CD8^+T细胞升高且CD4^+/CD8^+比值明显降低,提示儿童高IgE血症患者外周血中存在Th1,Th2细胞比例失衡以及T淋巴细胞亚群功能紊乱。

Objective To discuss the level and significance of complement（C3,C4） ,intenferon-γ（IFN-γ） ,interleukin-4（IL-4）, CD4＋ and CD8＋T lymphocytes in children with hyper blood IgE. Methods A total of 96 children with hyper blood IgE were selected from the outpatient clinlic of Fuzhou Children Hospital from February 2017 to January 2018 （high IgE group）. In addition, 82 children in the same period in the hospital were selected as the control group（control group）. The lev- el of complement C3,C4,IFN-7,IL-4,CD4＋ and CD8＋T lymphocytes in high IgE group and control group were detected. IFN-7/IL-4 and the CD4＋/CD8＋ ratio were calculated. Three kinds of allergic diseases in the high IgE group were also com- pared. Results The comparison of the indexes of complement （C3,C4 g/L）, IFN-γ（ng/L） and CD4＋ T lymphocytes（%） fruit：the high IgE group（1. 07±0. 21,0. 24±0. 06,19. 69±2. 97 and 31.07±4. 11 respectively） were significantly lower than the control group （1.31±0.06,0.35±0.07,25.12±5.05 and 35.21±6.47 respectively） ,t=9. 94,11. 24,8. 90,5.17, all P〈0.01）. IL-4 and CD8＋ T cells（ % ） two index comparison results：high IgE group （45.58± 8.79,36.96± 5.44 respec- tively） were higher than the control group （4.74±1.15,31.93±4.50 respectively） ,t=41.75,6.66,all P〈0.01）. The high IgE group of IFN-γ IL-4 and CD4＋/CD8＋ ratio （0.45 ±0.10,0.86 ± 0.19 respectively） and the control group （5.57 ±1.61,1.12 ± 0.25 respectively） were decreased significantly（t= 31.15,7.78, all P〈0.01）. The difference were statistically significant. High IgE three groups of allergic diseases among each was not statistically significant（P〉0.05）. Conclusion IL-4 significantly increased in children high blood IgE,and IFN-γ, IFN-γ/IL-4 were significantly reduced. The CD4＋T and CD4＋/CD8＋ lymphocyte ratio was obviously decreased, and the CD8＋T lymphocytes were higher, suggesting that it might have Thl ,Th2 cell imbalance. There was a dysfunction of T lymphocyte subgroup.