儿童呼吸道合胞病毒感染与哮喘发展的关系

Relationship between respiratory syncytial virus infection and asthma development in children

目的探讨儿童呼吸道合胞病毒(RSV)感染与哮喘之间的关系。方法采用直接免疫荧光法,对2017年3月至2018年3月湖州市妇幼保健院收治的90例患有哮喘的患儿(哮喘组)和30例健康的儿童(对照组)的鼻咽分泌物进行RSV抗原检测。检测RSV抗原呈现阳性的患儿对其血清中的IgE抗体进行检测,并检测患儿血清中细胞因子干扰素-γ(IFN-γ)、白细胞介素-2(IL-2)、白细胞介素-4(IL-4)的分泌水平,与正常儿童血清进行对照。结果 90例哮喘患儿中,检测出RSV抗原阳性共61例,占67.78%,与对照组相比呈显著性差异(t=5.34,P<0.05)。61例RSV抗原阳性者中检测其血清中IgE抗体分泌水平明显高于对照组,有显著性差异(t=6.21,P<0.05);血清中IFN-γ、IL-2分泌水平明显低于对照组,IL-4、IL-10分泌水平高于对照组,均有显著性差异(t值分别为5.33、5.21、5.13、4.94,均P<0.05)。结论儿童哮喘的发作与RSV感染关系密切,RSV的感染会造成呼吸道黏膜的损伤,引发哮喘的发生,并且感染RSV后对机体的免疫应答机制也产生了影响。Th1和Th2型细胞免疫均处于失衡状态,Th2型免疫细胞因子分泌水平增强,而Th1型细胞因子则受到抑制,导致了RSV感染后哮喘类疾病的发生。

Objective To explore the relationship between respiratory syncytial virus(RSV)infection and asthma in children.Methods Indirect enzyme-linked immunosorbent assay was used to detect RSV antigen in nasopharyngeal secretions of 90 children in asthma group and 30 healthy children in control group admitted in Huzhou Maternal and Child Health Care Hospital during March 2017 to March 2018.For children with RSV antigen positive,IgE antibody in serum was detected,and secretion levels of cytokines interferon-γ(IFN-γ),interleukin-2(IL-2)and interleukin-4(IL-4)were detected to make comparison with normal children.Results Among 90 asthmatic children,61 cases were RSV antigen positive,accounting for 67.78%of the total.Compared with the results of healthy children,there was significant difference(t=5.34,P<0.05).The serum IgE antibody levels of 61 children with RSV antigen positive were significantly higher than those of the control group(t=6.21,P<0.05).The levels of IFN-γand IL-2 were significantly lower but the levels of IL-4 and IL-10 were significantly higher than those of the control group(t value was 5.33,5.21,5.13 and 4.94,respectively,all P<0.05).Conclusion The onset of asthma in children is closely related to RSV infection.RSV infection can cause damage to respiratory mucosa and cause asthma,and influence the immune response mechanism.Th1 and Th2 type cellular immunity are in an unbalanced state.The secretion level of Th2 type immune cytokine is enhanced,while that of Th1 type cytokines is inhibited,which leads to the occurrence of asthmatic diseases after RSV infection.