哮喘孕妇血清微量元素和免疫功能指标的水平及意义

Levels and significance of serum trace elements and immune function indexes in pregnant women with asthma

目的检测哮喘孕妇血清微量元素和免疫功能指标水平,分析其相关性及意义。方法选取2018年6月—2020年6月湖州市中心医院呼吸科门诊收治的30例哮喘孕妇为哮喘组,同期在湖州市中心医院进行产检的30例健康孕妇为对照组。检测并比较两组孕妇血清微量元素(铁、锌、铜)和免疫功能指标(CD3^(+)T淋巴细胞亚群、CD4^(+)T淋巴细胞亚群、CD4^(+)/CD8^(+)T淋巴细胞亚群比值、IgG、IgA及IgM)水平,采用Pearson法分析哮喘组血清微量元素与免疫功能指标的相关性。结果对照组患者血清CD3^(+)T淋巴细胞亚群、CD4^(+)T淋巴细胞亚群、CD4^(+)/CD8^(+)T淋巴细胞亚群比值、IgG、IgA及IgM水平分别为(1.40±0.17)×10^(9)/L,(610.00±87.20)×10^(6)/L,(1.66±0.32),(13.98±1.11)g/L,(2.87±0.60)g/L及(2.07±0.26)g/L。哮喘组血清CD3^(+)T淋巴细胞亚群、CD4^(+)T淋巴细胞亚群、CD4^(+)/CD8^(+)T淋巴细胞亚群比值、IgG、IgA及IgM水平分别为(0.89±0.24)×10^(9)/L,(458.00±106.30)×10^(6)/L,(1.08±0.28),(10.12±1.91)g/L,(1.62±0.42)g/L及(1.67±0.46)g/L.哮喘组血清CD3^(+)T淋巴细胞亚群、CD4^(+)T淋巴细胞亚群、CD4^(+)/CD8^(+)T淋巴细胞亚群比值、IgG、IgA及IgM水平均显著低于对照组,两组比较差异均有统计学意义(t=9.394,6.055,7.393,9.564,9.405,4.140,均P<0.05)。哮喘组血清铁、锌、铜水平分别为(1.09±0.25)mg/L、(1.04±0.25)mg/L及(1.23±0.22)mg/L,对照组血清铁、锌、铜水平分别为(1.46±0.25)mg/L、(1.46±0.23)mg/L、(1.50±0.24)mg/L,哮喘组血清铁、锌、铜水平均显著低于对照组,两组比较差异均有统计学意义(t=5.752,6.750,4.752,均P<0.05)。Pearson相关性分析显示:哮喘组血清铁、锌、铜水平与CD4^(+)T淋巴细胞亚群、CD4^(+)/CD8^(+)T淋巴细胞亚群比值、IgG、IgA水平均呈正相关(均P<0.05),与IgM水平无相关性(均P>0.05)。结论哮喘孕妇存在着一定程度的免疫功能低下和微量元素缺乏,而微量元素缺乏又可进一步降低机体免疫功能,不利于控制哮喘。对孕妇进行微量元素检测,缺乏者尽早补充,可改善机体免疫功能,对妊娠期哮喘的防治有重要意义。

Objective To detect the levels and significance of serum trace elements and immune function indexes in pregnant women with asthma,analyze the correlations and significance.Methods From June 2018 to June 2020,30 pregnant women with asthma treated in Respiratory Clinic of Huzhou Central Hospital were selected as asthma group,30 healthy pregnant women were selected as control group.The levels of serum trace elements(iron,zinc,and copper)and immune function indexes(CD3^(+)T lymphocyte subgroup,CD4^(+)T lymphocyte subgroup,CD4^(+)/CD8^(+)T lymphocyte subgroup ratio,IgG,IgA,and IgM)in the two groups were detected and compared,the correlations between serum trace elements and immune function indexes in asthma group were analyzed by Pearson correlation analysis.Results The levels of serum CD3^(+)T lymphocyte subgroup,CD4^(+)T lymphocyte subgroup,CD4^(+)/CD8^(+)T lymphocyte subgroup ratio,IgG,IgA,and IgM in control group were(1.40±0.17)×10^(9)/L,(610.00±87.20)×10^(6)/L,(1.66±0.32),(13.98±1.11)g/L,(2.87±0.60)g/L,and(2.07±0.26)g/L,respectively.The levels of serum CD3^(+)T lymphocyte subgroup,CD4^(+)T lymphocyte subgroup,CD4^(+)/CD8^(+)T lymphocyte subgroup ratio,IgG,IgA,and IgM in asthma group were(0.89±0.24)×10^(9)/L,(458.00±106.30)×10^(6)/L,(1.08±0.28),(10.12±1.91)g/L,(1.62±0.42)g/L,and(1.67±0.46)g/L,respectively.The levels of serum CD3^(+)T lymphocyte subgroup,CD4^(+)T lymphocyte subgroup,CD4^(+)/CD8^(+)T lymphocyte subgroup ratio,IgG,IgA,and IgM in asthma group were statistically significantly lower than those in control group(t=9.394,6.055,7.393,9.564,9.405,4.140,P<0.05).The levels of serum iron,zinc,and copper in asthma group were(1.09±0.25)mg/L,(1.04±0.25)mg/L,and(1.23±0.22)mg/L,respectively,the levels of serum iron,zinc,and copper in control group were(1.46±0.25)mg/L,(1.46±0.23)mg/L,and(1.50±0.24)mg/L,respectively,the levels of serum iron,zinc,and copper in asthma group were statistically significantly lower than those in control group(t=5.752,6.750,4.752,P<0.05).Pearson correlation analysis showed that in asthma group,the levels of serum iron,zinc,and copper were positively correlated with CD4^(+)T lymphocyte subgroup,CD4^(+)/CD8^(+)T lymphocyte subgroup ratio,IgG,and IgA levels,respectively(P<0.05),which were not correlated with IgM level(P>0.05).Conclusion Low immune function and trace element deficiency are observed in pregnant women with asthma,trace element deficiency further reduces immune function,which is not conducive to disease control.Conducting trace element detection and supplementation of trace elements for the pregnant women with trace element deficiency can improve immune function and play an important role in prevention and treatment of pregnant women with asthma.