哮喘儿童血免疫球蛋白E、T细胞亚群与细胞因子动态观察及临床意义

Clinical significance and dynamic changes of serum immunoglobulin E,Tcell subgroups and cytokines in asthmatic children

目的 探讨 45例哮喘患儿血免疫球蛋白E(IgE)、T细胞亚群与细胞因子的动态变化 ,细胞因子与IgE之间的关系 ,为长期防治和规范管理儿童哮喘提供理论依据。 方法 T细胞亚群测定采用单克隆抗体间接免疫荧光法。IgE及白细胞介素 (IL) 2、IL 4、IL 6、IL 8、干扰素 γ(IFN γ)等细胞因子测定采用双抗夹心酶联免疫吸附试验 (ELISA)分析方法。结果 哮喘发作期、缓解期CD3 + 、CD4+ 、CD4+ /CD8+ 与对照组比较均有显著性差异 (P <0 .0 5,P <0 .0 1,P <0 .0 5) ;CD8+ 无明显差异 (P均 >0 .0 5) ;发作期IL 2、IFN α显著低于对照组(P <0 .0 0 1,P <0 .0 5) ;IL 4、IL 6、IL 8、IgE显著高于对照组 (P <0 .0 1,P <0 .0 5,P <0 .0 1,P <0 .0 1)。哮喘缓解期IL 2、IFN γ显著低于对照组 (P均 <0 .0 0 1) ,IL 4、IL 8、IgE明显高于对照组 (P <0 .0 5,P <0 .0 5,P <0 .0 0 1)。IL 6缓解期与对照组比较无显著性差异 (P >0 .0 5)。结论 变应性哮喘患儿发作期和缓解期仍存在免疫失衡状态 ,表现CD4+ T细胞增多 ,功能亢进 ,CD8+ T细胞数量和 (或 )功能不足导致免疫功能紊乱是哮喘的主要发病机制 ,提示哮喘患儿在缓解期也应继续进行抗变态反应性炎症治疗。

Objective To investigate the changes of serum immunoglobulin E(IgE)?T cell subgroups and cytokines in asthmatic children and to provide theoretical basis for the management of asthmatic children.Methods T cell subgroups were determined by indirect immuofluorence method mono clone antibody, the detection of IgE,interleukin(IL) 4,IL 6,IL 8,interferon γ(IFN γ) were done by ELISA method, and 20 normal children were served as control group.Results There were significant differences of CD3 +,CD4 +,CD4 +/CD8 + among the stages of exacerbation and convalescence of asthmatic children and control group.( P<0.05,P<0.01,P < 0.05 ),but there was no difference of CD8 +( P >0.05).In the stage of convalescence the levels of IL 2,IFN γ were lower than control group( P<0.001,P <0.05);the levels of IL 4,IL 6, IL 8 and IgE were higher than control group( P<0.01,P<0.05,P< 0.001 , P <0.001); the levels of IL 2,IFN γ were lower than control group in the stage of convalescence( P < 0.001); the levels of IL 4, IL 8 ,and IgE were significantly higher than control group( P <0.05, P<0.05, P < 0.001). The levels of IL 6 showed no difference in allergic asthmatic patients in the convalescence stage compared with control group( P >0.05).Conclusions Allergic asthmatic patients between the exacerbation and convalescence stages still had immunologic imbalance,indicating increased number of CD4 +T cell(mainly Th2 cells)and hyperfunction;the insufficient number and(or) the inactivity of CD8 +T cell may induce immunological disturbance ,which is the major mechanism of asthmatic attacks. These findings suggest the patients in an abnormal immunological state should receive continuous anti allergic therapy.