嗜碱性粒细胞活化状态对哮喘患儿急性发作次数的影响分析

Analysis of the effect of basophil activation on the number of acute attacks in children with asthma

目的探讨嗜碱性粒细胞活化状态对哮喘患儿急性发作次数的影响分析。方法选取2015年3月-2016年5月我院收治的哮喘急性发作期患儿57例,根据其病情严重程度分为:轻度组:轻度患者24例和中重度组:中重度患者33例。另选取同期健康体检儿童40例。采用流式细胞仪检测外周血嗜碱性粒细胞中CD63、CD203c水平和化学发光免疫分析法检测血清总Ig E水平。观察哮喘患儿经治疗临床症状及体征缓解后,随访追踪12个月,记录随访期内哮喘患儿急性发作次数和严重程度。结果哮喘患儿急性发作期血清总Ig E水平高于缓解期和健康儿童,差异有统计学意义(P<0.05);哮喘轻度患儿CD63、CD203c水平与中重度患儿相比,无显著性差异(P>0.05);每年发病超过5次的哮喘患儿CD63、CD203c水平均较每年发病不足5次的哮喘患儿高,差异有统计学意义(P<0.001);在随访12个月内,血清IgE、CD63、CD203c水平越高,急性发作次数越多,呈正相关(r=0.513,r=1.17,r=0.876,P<0.05)。结论哮喘患儿急性发作期血清总IgE、CD63、CD203c水平上升,与其预后密切相关:血清IgE、CD63、CD203c水平越高,患儿急性发作次数越多,与病情严重程度无关。

Objective To investigate the effect of basophil activation on the frequency of acute attack in children with asthma. Methods From March 2015 to May 2016,57 children with acute attack of asthma in our hospital were treated. According to the severity of the disease,they were divided into the mild group（ 24 cases） and the moderate and severe group（ 33 cases）. Another 40 healthy children were selected at the same period. The levels of CD63 and CD203 c in peripheral blood basophils were detected by flow cytometry,and the levels of serum total Ig E were detected by chemiluminescence immunoassay. The clinical symptoms and signs of children with asthma were relieved and followed up for 12 months. The number and severity of acute attack of asthma in children during follow-up period were recorded. Results The total Ig E level in serum was higher in the acute group than in the remission group and the control group（ P〈0. 05）. There was no significant difference in CD63 and CD203 c between the mild group and the moderate group（ P〉0. 05）. The levels of CD63 and CD203 c were obviously higher in children with more than 5 asthma attacks per year than in children with less than 5 times asthma attack（ P〈0. 001）. During the12-month follow-up,the serum levels of Ig E,CD63 and CD203 c were positively correlated with the frequency of acute attack（ r = 0. 513,r = 1. 17,r = 0. 876,P〈0. 05）. Conclusion The levels of total IgE,serum CD63 and CD203 c increase in children with acute asthma,which are closely related with the prognosis. The higher the levels of serum IgE,CD63,and CD203 c are,the more the number of acute attack occurs,and the worse the severity of the disease is.