特布他林联合布地奈德治疗儿童哮喘对炎性细胞因子的影响及其遗传因素分析

Effects of Terbutaline Combined with Budesonide on Inflammatory Cytokines in Children with Asthma and Analysis of Its Genetic Factors

目的:探讨特布他林联合布地奈德治疗儿童哮喘对炎性细胞因子的影响以及儿童哮喘的相关遗传危险因素。方法:选取2015年2月至2017年2月于我院接受诊治的儿童支气管哮喘46例,随机分为研究组(特布他林联合布地奈德治疗)和对照组(布地奈德治疗)各23例,观察治疗前后炎性细胞因子的变化。采用问卷调查收集患儿相关疾病史及家族史,并进行相关基因检测,分析儿童哮喘的遗传危险因素。结果:研究组血清白细胞介素(IL)-4、IL-5、IL-17水平低于对照组(P<0.05),干扰素γ(IFN-γ)水平与对照组比较差异无统计学意义(P>0.05)。哮喘患儿中有家族史的占69.57%;一级亲属存在过敏性疾病有21例(91.30%),二级亲属中存在过敏性疾病有8例(53.33%),差异有统计学意义(P<0.05)。哮喘患儿ORMDL3基因中rs7216389位点TT基因型频率最高(59.38%),而TC、CC基因型频率分别为25.00%、15.62%。结论:特布他林联合布地奈德治疗儿童哮喘可降低炎性细胞因子水平,有利于控制气管炎症反应,提高治疗效果。存在哮喘家族史、过敏性疾病家族史以及ORMDL3基因rs7216389-TT的表达系哮喘遗传的危险因素。

Objective:To probe into the effects of terbutaline combined with budesonide on inflammatory cytokines in children with asthma and the genetic risk factors associated with asthma.Methods:Totally 46 children with bronchial asthma admitted into our hospital from Feb.2015 to Feb.2017 were extracted to be randomly divided into the study group(terbutaline combined with budesonide treatment)and the control group(budesonide treatment),with 23 cases in each group.Changes of inflammatory cytokines were observed before and after treatment.Questionnaire survey was used to collect the related disease history and family history of the children,and relevant genetic tests were performed to analyze the genetic risk factors of asthma in children.Results:The serum levels of IL-4,IL-5 and IL-17 in the study group were significantly lower than those in the control group(P<0.05),and there was no statistically significant difference in serum levels of IFN-γcompared with the control group(P>0.05).Totally 69.57%children with asthma had family history.There were 21 cases(91.30%)of first-degree relatives with allergic diseases,and 8 cases(53.33%)of second-degree relatives with allergic diseases,the difference was statistically significant(P<0.05).The highest frequency of TT genotype(59.38%)was found in the ORMDL3 gene in children with asthma at locus rs7216389,while the frequency of TC and CC genotype was respectively 25.00%and 15.62%.Conclusion:Terbutaline combined with budesonide can reduce the levels of inflammatory cytokines in children with asthma,which is conducive to controlling the inflammatory response of trachea and improving the treatment effects.The family history of asthma,family history of allergic diseases and expression of ORMDL3 gene rs7216389-TT are genetic risk factors for asthma.