支气管哮喘合并呼吸道病毒感染患儿的免疫功能与气道重塑和炎症反应的相关性

Correlation of immune function with airway remodeling and inflammatory reaction in children with bronchial asthma complicated with respiratory virus infection

目的探讨支气管哮喘合并呼吸道病毒感染患儿的免疫功能与气道重塑、炎症反应的相关性。方法选取40例支气管哮喘合并呼吸道病毒感染患儿作为观察组,40例单纯支气管哮喘患儿作为对照组。比较两组患儿血清免疫功能指标(CD3~+T淋巴细胞、CD4~+T淋巴细胞、CD8~+T淋巴细胞、CD4~+/CD8~+比值),炎症反应指标[白细胞介素(IL)-4、IL-5、肿瘤坏死因子α(TNF-α)],以及右肺上叶尖段与左肺下叶后基底段的气道重塑指标[气道管腔面积(LA)、气道管壁面积(WA)、气道总面积(TA)]。分析支气管哮喘合并呼吸道病毒感染患儿免疫功能指标与气道重塑指标、炎症反应指标的相关性。结果观察组患儿血清CD3~+T淋巴细胞、CD4~+T淋巴细胞水平及CD4~+/CD8~+比值均低于对照组,而血清CD8~+T淋巴细胞、IL-4、IL-5、TNF-α水平均高于对照组(均P<0.05);观察组患儿右肺上叶尖段及左肺下叶后基底段的LA、WA、TA均小于对照组(均P<0.05)。支气管哮喘合并呼吸道病毒感染患儿血清CD3~+T淋巴细胞、CD4~+T淋巴细胞水平及CD4~+/CD8~+比值与右肺上叶尖段及左肺下叶后基底段的LA、WA、TA均呈正相关,与血清IL-4、IL-5、TNF-α水平均呈负相关(均P<0.05),而血清CD8~+T淋巴细胞水平与右肺上叶尖段及左肺下叶后基底段的LA、WA、TA均呈负相关,与血清IL-4、IL-5、TNF-α水平均呈正相关(均P<0.05)。结论相比于单纯支气管哮喘患儿,支气管哮喘合并呼吸道病毒感染患儿的免疫功能受损程度,气道重塑反应与炎症反应更严重。随着免疫功能的降低,支气管哮喘合并呼吸道病毒感染患儿的气道重塑反应与炎症反应越严重。

Objective To investigate the correlation of immune function with airway remodeling and inflammatory reaction in children with bronchial asthma complicated with respiratory virus infection.Methods A total of 40 children with bronchial asthma complicated with respiratory virus infection were selected as observation group,and 40 children with simple bronchial asthma as control group.The serum immune function indexes(CD3+T lymphocyte,CD4+T lymphocyte,CD8+T lymphocyte,and CD4+/CD8+ratio),inflammatory reaction indexes(interleukin[IL]-4,IL-5,and tumor necrosis factorα[TNF-α]),and airway remodeling indexes of upper lobe apical segment of right lung and lower lobe posterior basal segment of left lung(lumen area[LA],wall area[WA],and total airway area[TA])were compared between the two groups.The correlation of immune function indexes with airway remodeling indexes and inflammatory reaction indexes in children with bronchial asthma complicated with respiratory virus infection was analyzed.Results The serum CD3+T lymphocyte,CD4+T lymphocyte levels and the ratio of CD4+/CD8+in the observation group were lower than those in the control group,while the serum CD8+T lymphocyte,IL-4,IL-5 and TNF-αlevels were higher than those in the control group(all P<0.05).The LA,WA and TA of upper lobe apical segment of right lung and lower lobe posterior basal segment of left lung in the observation group were smaller than those in the control group(all P<0.05).The serum CD3+T lymphocyte,CD4+T lymphocyte levels and the ratio of CD4+/CD8+in children with bronchial asthma complicated with respiratory virus infection positively correlated with LA,WA and TA of upper lobe apical segment of right lung and lower lobe posterior basal segment of left lung,and negatively correlated with the levels of serum IL-4,IL-5 and TNF-α(all P<0.05);however,the level of serum CD8+T lymphocyte negatively correlated with LA,WA and TA of upper lobe apical segment of right lung and lower lobe posterior basal segment of left lung,and positively correlated with the levels of serum IL-4,IL-5 and TNF-α(all P<0.05).Conclusion In the comparison of children with simple bronchial asthma,the degree of immune function impairment,airway remodeling reaction,and inflammatory reaction are more severe in children with bronchial asthma complicated with respiratory virus infection.With the decline of the children′s immune function,the airway remodeling reaction and inflammatory reaction are more severe in children with bronchial asthma complicated with respiratory virus infection.