本文選題：毛細支氣管炎　切入點：兒童　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：毛細支氣管炎是2歲以下嬰幼兒特有的呼吸系統(tǒng)疾病，主要由呼吸道合胞病毒感染引起。臨床上主要表現(xiàn)為咳嗽、呼吸困難及喘憋，嚴(yán)重者可合并呼吸衰竭、心力衰竭等，嚴(yán)重威脅患兒的生命。目前對本病尚無有效的治療方法，以對癥支持治療為主。毛細支氣管炎的發(fā)病機制十分復(fù)雜，多種免疫細胞及免疫分子參與其發(fā)病過程。MIP-1α是CC趨化因子家族即β趨化因子家族，主要趨化CD4+T細胞、CD8+T細胞、單核細胞、嗜酸性粒細胞、肥大細胞、嗜堿性粒細胞等浸潤，并能增強其活性，激活的免疫細胞釋放多種炎性介質(zhì)，破壞氣道上皮細胞。此外，MIP-1α還能誘導(dǎo)嗜酸性粒細胞釋放ECP，刺激肥大細胞、嗜堿性粒細胞釋放組胺。ECP是嗜酸性粒細胞活化后釋放的一種堿性蛋白，是嗜酸性粒細胞活化的標(biāo)志。ECP能誘導(dǎo)肥大細胞釋放組胺，并且能直接損傷呼吸道上皮細胞，導(dǎo)致細胞脫落，引起氣道高反應(yīng)。國內(nèi)外對于MIP-1α在毛細支氣管炎中的作用方面研究比較少,而對于急性期毛細支氣管炎血清中ECP水平是否升高，目前尚存在爭議。為此，我們對毛細支氣管炎患兒血清中MIP-1α及ECP的水平進行檢測。 研究目的：探討毛細支氣管炎患兒血清中MIP-1α、ECP的水平及臨床意義，并分析急性期MIP-1α、ECP水平的高低與患兒日后喘息的關(guān)系。 研究方法： 本實驗選取2010年11月至2011年12月在吉林大學(xué)第一醫(yī)院小兒呼吸科明確診斷為毛細支氣管炎的患兒為研究對象，同時選取同期因睪丸鞘膜積液、腹股溝斜疝、臍疝入住我院小兒外科無感染性疾病的患兒作為對照組。采用雙抗體夾心酶聯(lián)免疫吸附法（ELISA）測定毛細支氣管炎患兒急性期、恢復(fù)期及對照組血清中MIP-1α、ECP水平。毛細支氣管炎患兒治愈后隨訪6~12個月，，觀察有無喘息發(fā)作。所有數(shù)據(jù)應(yīng)用SPSS17.0軟件進行統(tǒng)計學(xué)分析。 研究結(jié)果： 1.毛細支氣管炎患兒急性期血清中MIP-1α、ECP水平高于恢復(fù)期和對照組，差異有統(tǒng)計學(xué)意義（P＜0.01）； 2.毛細支氣管炎患兒恢復(fù)期血清中MIP-1α、ECP水平仍高于對照組，差異有統(tǒng)計學(xué)意義（P＜0.05）； 3.毛細支氣管炎治愈后再次發(fā)生喘息的患兒急性期血清中MIP-1α、ECP水平高于未再發(fā)生喘息的患兒，差異有統(tǒng)計學(xué)意義（P＜0.05）； 4.毛細支氣管炎患兒急性期血清中MIP-1α與ECP呈正相關(guān)，r=0.646，P＜0.01。 結(jié)論： 1.毛細支氣管炎患兒急性期血清中MIP-1α、ECP水平高于對照組，恢復(fù)期血清中兩者水平較急性期下降，但仍高于對照組，提示MIP-1α、ECP可能在毛細支氣管炎發(fā)病中發(fā)揮一定作用； 2.毛細支氣管炎患兒急性期血清中MIP-1α、ECP水平越高，毛細支氣管炎治愈后發(fā)生喘息的可能性越大； 3.毛細支氣管炎患兒急性期血清中MIP-1α與ECP水平呈正相關(guān)。
[Abstract]:Background: bronchiolitis is a special respiratory disease in infants under 2 years of age. It is mainly caused by respiratory syncytial virus infection. Heart failure and other serious threats to the life of children. There is no effective treatment for this disease, mainly for symptomatic support treatment. The pathogenesis of bronchiolitis is very complex. Many kinds of immune cells and immunomolecules participate in its pathogenesis. MIP-1 偽 is a family of CC chemokines, that is, 尾 chemokines, mainly chemotaxis of CD4 T cells, monocytes, eosinophils, mast cells, basophil, and so on, and mainly chemotaxis of CD8 T cells, monocytes, eosinophils, basic granulocytes, and so on. In addition, MIP-1 偽 can also induce eosinophils to release ECPs and stimulate mast cells. Eosinophil releasing histamine. ECP is a basic protein released after eosinophil activation. ECP can induce mast cells to release histamine and directly damage respiratory epithelial cells. There are few studies on the role of MIP-1 偽 in bronchiolitis at home and abroad, but it is still controversial whether the level of ECP in serum of acute bronchiolitis is elevated. The levels of MIP-1 偽 and ECP in serum of children with bronchiolitis were determined. Objective: to investigate the level and clinical significance of MIP-1 偽 in the serum of children with bronchiolitis, and to analyze the relationship between the level of MIP-1 偽 and wheezing in children with bronchiolitis. Research methods:. From November 2010 to December 2011, children who were diagnosed as bronchiolitis in the Department of Pediatric ventilation, first Hospital of Jilin University, were selected as subjects. Meanwhile, indirect inguinal hernia due to testicular hydrocele was selected. Umbilical hernia children admitted to our hospital as control group were examined for the acute phase of bronchiolitis by double antibody sandwich enzyme-linked immunosorbent assay (Elisa). The serum levels of MIP-1 偽 in the convalescent group and the control group were followed up for 612 months after the recovery of bronchiolitis. All the data were analyzed statistically by SPSS17.0 software. Results of the study:. 1. The levels of MIP-1 偽 in acute bronchitis were significantly higher than those in convalescent and control groups (P < 0.01). 2. The serum level of MIP-1 偽 in children with bronchiolitis was still higher than that in the control group (P < 0.05). 3. The level of MIP-1 偽 in the serum of the children with bronchiolitis was higher than that of the children without asthma in the acute phase, and the difference was statistically significant (P < 0.05). 4. There was a positive correlation between serum MIP-1 偽 and ECP in children with bronchiolitis at acute stage (P < 0.01). Conclusion:. 1. The levels of MIP-1 偽 in the acute phase of bronchiolitis were higher than those in the control group, and the levels of both in the convalescent phase were lower than those in the acute phase, but still higher than those in the control group, suggesting that MIP-1 偽 may play a role in the pathogenesis of bronchiolitis. 2. The higher the level of MIP-1 偽 in the serum of children with bronchiolitis, the greater the possibility of wheezing after bronchiolitis was cured. 3. There was a positive correlation between serum MIP-1 偽 and ECP levels in children with bronchiolitis.
【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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