發(fā)布時間：2018-02-10 21:36

  本文關(guān)鍵詞： 支氣管哮喘 特應(yīng)性 白介素-10（IL-10） 血漿內(nèi)皮素-1（ET-1） 免疫球蛋白E（IgE）　出處：《吉林大學(xué)》2012年碩士論文　論文類型：學(xué)位論文

【摘要】：研究背景和目的:支氣管哮喘發(fā)病機(jī)制復(fù)雜，免疫、遺傳、環(huán)境等多種因素影響著哮喘的發(fā)生與發(fā)展，已經(jīng)成為當(dāng)今世界威脅公共健康最常見的慢性肺部疾病之一，尤其在兒童中。目前關(guān)于喘息性疾病的發(fā)展歷程，有兩種發(fā)展歷程受到廣泛關(guān)注，主要包括過敏歷程和感染歷程，其中過敏歷程主要是指從變應(yīng)性皮炎到過敏性鼻炎、支氣管哮喘的發(fā)展歷程。過敏體質(zhì)與支氣管哮喘的關(guān)聯(lián)得到一致認(rèn)可。本研究通過檢測特應(yīng)性與非特應(yīng)性哮喘患兒血清白介素-10（IL-10）、血漿內(nèi)皮素-1（ET-1）及免疫球蛋白E水平，旨在探討哮喘患兒尤其是特應(yīng)性哮喘患兒血清IL-10、ET-1的表達(dá)情況及臨床意義。 研究方法:隨機(jī)選擇吉林大學(xué)第一醫(yī)院2010年1月至2010年10月兒科住院患兒，按中華醫(yī)學(xué)會兒科學(xué)分會呼吸學(xué)組2008年修訂的《兒童支氣管哮喘診斷與防治指南》及《全球哮喘防治創(chuàng)議》（GINA）診斷標(biāo)準(zhǔn)，，診斷為支氣管哮喘患兒60例作為觀察對象，同時應(yīng)用過敏原皮膚點(diǎn)刺試驗(yàn)和血清IgE測定確定患兒的特應(yīng)性狀態(tài)，并根據(jù)結(jié)果分為特應(yīng)性哮喘組和非特應(yīng)性哮喘組，特應(yīng)性組32例，非特應(yīng)性組28例。32例特應(yīng)性哮喘患兒中，男性18例，女性14例，年齡范圍3～14歲，中位年齡6.4歲；28例非特應(yīng)性哮喘患兒中，男性15例，女性13例，年齡范圍2～13歲，中位年齡7.2歲。并選取同期30名體檢正常兒童作為健康對照組，其中男性17例，女性13例，年齡3～14歲，中位年齡6.3歲。應(yīng)用ELISA酶聯(lián)免疫吸附試驗(yàn)檢測各組血清IL-10、ET-1及IgE的含量。 研究結(jié)果： 1．哮喘組患兒發(fā)作期血清IL-10水平低于緩解期和正常對照組，差異有統(tǒng)計(jì)學(xué)意義（P 0.05），ET-1和IgE水平明顯高于緩解期和正常對照組，差異有統(tǒng)計(jì)學(xué)意義（P 0.01）。 2．哮喘組患兒緩解期IL-10水平低于對照組，ET-1水平高于對照組，但差異無統(tǒng)計(jì)學(xué)意義（P0.05），IgE水平高于對照組，兩組間差異有統(tǒng)計(jì)學(xué)意義（P 0.01）。 3．發(fā)作期特應(yīng)性組IL-10水平與非特應(yīng)性組比較，差異有統(tǒng)計(jì)學(xué)意義（P 0.05），緩解期特應(yīng)性組IL-10水平與非特應(yīng)性組比較，差異無統(tǒng)計(jì)學(xué)意義（P0.05）；特應(yīng)性組ET-1、IgE水平在發(fā)作期和自身緩解期均高于非特應(yīng)性組，差異有統(tǒng)計(jì)學(xué)意義（P 0.01）。 結(jié)論： 1．哮喘患兒血清中IL-10水平降低，ET-1和IgE水平升高，提示IL-10、ET-1及IgE可能參與了小兒哮喘的病理生理過程。 2．哮喘患兒特應(yīng)性組較非特應(yīng)性組血清IL-10、ET-1及IgE水平改變程度更明顯，提示IL-10、ET-1及IgE可能與特應(yīng)性有關(guān)。 3．哮喘發(fā)作期血清IL-10低水平表達(dá)，ET-1及IgE高水平表達(dá)，IL-10的水平與ET-1及IgE間分別呈明顯負(fù)相關(guān)，ET-1與IgE呈明顯正相關(guān)。
[Abstract]:Background and objective: asthma has become one of the most common chronic lung diseases threatening public health in the world because of its complex pathogenesis, immunity, heredity, environment and other factors affecting the occurrence and development of asthma. Especially among children. At present, there are two kinds of development processes of wheezing diseases that have received extensive attention, mainly including allergic process and infection process, among which allergic process mainly refers to allergic dermatitis to allergic rhinitis. The relationship between allergic constitution and bronchial asthma was unanimously recognized. In this study, the levels of serum interleukin-10 (IL-10), plasma endothelin-1 (ET-1) and immunoglobulin E (IgE) were measured in children with atopic and non-atopic asthma. To investigate the expression and clinical significance of IL-10 ET-1 in children with asthma, especially in children with atopic asthma. Methods: pediatric hospitalized children were randomly selected from January 2010 to October 2010 in the first Hospital of Jilin University. According to the guidelines for the diagnosis and treatment of bronchial Asthma in Children, revised in 2008 by the Respiratory Group of the Chinese Academy of Pediatrics, and according to the diagnostic criteria of Global Asthma Prevention and treatment, 60 children with bronchial asthma were diagnosed as subjects of observation. At the same time, the anaphylaxis skin prick test and serum IgE test were used to determine the atopic status of the children. According to the results, they were divided into atopic asthma group and non-atopic asthma group (n = 32), atopic group (n = 32), non-atopic group (n = 28), and non-atopic group (n = 28). There were 18 males, 14 females, and the age range was 314 years. The median age was 6.4 years old and 28 children with non-atopic asthma, 15 males and 13 females, the age ranged from 2 to 13 years. The median age was 7.2 years, and 30 healthy children in the same period were selected as the healthy control group, including 17 males and 13 females, aged 314 years, with a median age of 6.3 years. The levels of IL-10 ET-1 and IgE in serum were detected by ELISA enzyme-linked immunosorbent assay (Elisa). Results of the study:. 1. The level of serum IL-10 in asthmatic group was lower than that in remission group and normal control group, and the difference was statistically significant (P 0.05). The levels of ET-1 and IgE were significantly higher in asthmatic group than in remission stage and normal control group (P < 0.01). 2. The level of IL-10 in asthmatic group was lower than that in control group in remission period, but there was no significant difference between the two groups (P 0.05). The difference between the two groups was statistically significant (P 0.01). 3.Compared with the non-atopic group, the level of IL-10 in the atopic group was significantly higher than that in the non-atopic group (P 0.05), and the IL-10 level in the atopic group in the remission stage was higher than that in the non-atopic group. The level of ET-1 IgE in the atopic group was higher than that in the non-atopic group at the attack stage and the self-remission stage, and the difference was statistically significant (P 0.01). Conclusion:. 1. The serum levels of IL-10 and IgE in asthmatic children decreased, suggesting that IL-10 et-1 and IgE might be involved in the pathophysiological process of asthma in children. 2. The changes of serum IL-10ET-1 and IgE levels in asthmatic children were more obvious than those in non-atopic group, suggesting that IL-10t- ET-1 and IgE might be related to atopic status. 3. The low level of serum IL-10 and the high level of IgE expression of IL-10 were negatively correlated with ET-1 and IgE in asthmatic attack. There was a significant positive correlation between ET-1 and IgE.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：R725.6

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