嬰幼兒喘息性疾病血清IL-4、IFN-γ及尿LTE4濃度變化及意義研究
發(fā)布時(shí)間：2018-09-01 05:18
【摘要】：目的： 通過檢測(cè)嬰幼兒喘息患兒、非喘息患兒不同時(shí)期及正常健康兒血清白介素-4（IL-4）、干擾素-γ（IFN-γ）及尿白三烯（LTE4）水平，探討血清IL-4、IFN-γ及尿LTE4在嬰幼兒喘息性疾病病情發(fā)展中的作用及相互關(guān)系；從而探討嬰幼兒喘息性疾病的可能發(fā)病機(jī)制，為臨床治療嬰幼兒喘息性疾病提供一定的理論依據(jù)。 方法： 選擇2011年1月至2011年12月在我院兒科門診和住院的嬰幼兒（年齡3歲）。采用競(jìng)爭(zhēng)性酶聯(lián)免疫吸附分析法（ELISA）檢測(cè)22例急性期、恢復(fù)期因喘息性疾病就診的患兒（喘息組），排除大氣道梗阻、氣道異物及心源所致喘息，20例急性期、恢復(fù)期非喘息的下呼吸道感染患兒（非喘息組），20例健康體檢兒（正常對(duì)照組）血清IL-4、IFN-γ及尿LTE4水平。三組在年齡、性別上無顯著性差異，入組前四周均未使用激素類藥物及白三烯調(diào)節(jié)劑。收集喘息組、非喘息組急性發(fā)作期/恢復(fù)期及正常健康對(duì)照組兒童的血、尿標(biāo)本。標(biāo)本收集后均離心后冷凍保存，應(yīng)用SPSS13.0軟件就上述結(jié)果進(jìn)行統(tǒng)計(jì)分析。 結(jié)果： 1.各組血清IL-4水平的比較：喘息組急性期血清IL-4水平較非喘息組急性期及正常對(duì)照組均明顯升高（P＜0.01），均有統(tǒng)計(jì)學(xué)意義；恢復(fù)期（臨床緩解期）血清IL-4水平較急性期明顯下降(P＜0.01)，與非喘息組恢復(fù)期比較差異無統(tǒng)計(jì)學(xué)意義（P＞0.05），但仍高于正常對(duì)照組(P＜0.01)，有統(tǒng)計(jì)學(xué)意義。 2.各組血清IFN-γ水平的比較：喘息組急性發(fā)作期血清IFN-γ水平較非喘息組急性期及正常對(duì)照組均明顯降低(P＜0.01)，恢復(fù)期血清IFN-γ水平較急性期明顯升高(P＜0.01)，但仍低于非喘息組恢復(fù)期和正常對(duì)照組(P＜0.01)，均有統(tǒng)計(jì)學(xué)意義。 3.各組血清IL-4/IFN-γ比值的比較：喘息組急性期血清IL-4/IFN-γ比值較非喘息組急性期及正常對(duì)照組均明顯升高（F=15.86，P＜0.01）；恢復(fù)期血清IL-4/IFN-γ比值較急性期明顯下降(t=4.14，P＜0.01)，但仍高于非喘息組恢復(fù)期及正常對(duì)照組，且有統(tǒng)計(jì)學(xué)差異(F=19.98，P＜0.01)。 4.各組尿LTE4水平的比較：喘息組急性期尿LTE4水平較正常對(duì)照組明顯升高(P＜0.01)，有統(tǒng)計(jì)學(xué)意義，但與非喘息組急性期比較差異無統(tǒng)計(jì)學(xué)意義（P＞0.05）�；謴�(fù)期尿LTE4水平較急性期明顯降低(P＜0.01)，但仍高于非喘息組恢復(fù)期和正常對(duì)照組(P＜0.01)，有統(tǒng)計(jì)學(xué)意義。 5.血清IL-4、IFN-γ與尿LTE4水平相關(guān)性分析：喘息組急性期血清IL-4與尿LTE4呈正相關(guān)（r=0.823，，P＜0.01）；喘息組急性期血清IFN-γ與尿LTE4與呈負(fù)相關(guān)（r=-0.806，P＜0.01），均有統(tǒng)計(jì)學(xué)意義。 結(jié)論： 1.嬰幼兒喘息組急性發(fā)作期血清IL-4水平均高于非喘息組及正常對(duì)照組，且隨著病情的緩解而下降，但緩解期仍高于非喘息組及正常對(duì)照組，提示IL-4參與了喘息性疾病的急性發(fā)作及慢性持續(xù)的炎癥反應(yīng)。 2.嬰幼兒喘息組急性期血清IFN-γ水平低于非喘息組、正常對(duì)照組，病情緩解后血清IFN-γ水平升高，但仍低于非喘息組及正常對(duì)照組，提示IFN-γ亦參與了喘息的發(fā)作。 3.嬰幼兒喘息組急性期血清IL-4/IFN-γ較非喘息組急性期及正常對(duì)照組均明顯升高，且隨著病情的緩解而下降，但緩解期仍高于非喘息組及正常對(duì)照組，提示喘息患兒早期即存在Th1/Th2免疫失衡，Th2占優(yōu)勢(shì)，為早期對(duì)喘息性疾病患兒給予干預(yù)提供理論依據(jù)。 4.嬰幼兒喘息組急性期尿LTE4水平均高于非喘息組及正常對(duì)照組，且隨著病情的緩解而下降，但緩解期仍高于非喘息組及正常對(duì)照組，提示CysLTs參與了喘息性疾病的急性發(fā)作及慢性持續(xù)的炎癥反應(yīng)。 5.喘息患兒急性發(fā)作期血清IL-4水平與尿LTE4水平有顯著的正相關(guān)性，血清IFN-γ與尿LTE4水平呈顯著的負(fù)相關(guān)，提示IL-4、IFN-γ與CysLTs可能共同參與了喘息性疾病的急性發(fā)作，且兩者之間可能具有促進(jìn)和抑制作用，從而加重喘息的發(fā)生與發(fā)展。 6.喘息患兒血清IL-4、尿LTE4水平持續(xù)升高、IFN-γ水平降低， Th1/Th2免疫失衡可能是導(dǎo)致嬰幼兒喘息的重要原因之一，為臨床施行免疫干預(yù)，調(diào)整Th1/Th2免疫失衡，使用白三烯受體拮抗劑治療嬰幼兒喘息性疾病提供了一定的理論依據(jù)。
[Abstract]:Objective:
To investigate the role of serum interleukin-4 (IL-4), interferon-gamma (IFN-gamma) and urinary leukotriene (LTE4) in the development of infantile wheezing diseases, and to explore the possible relationship between serum IL-4, IFN-gamma and urinary LTE4 in the development of infantile wheezing diseases. Pathogenesis provides a theoretical basis for clinical treatment of wheezing diseases in infants.
Method:
From January 2011 to December 2011, 22 infants (3 years old) with acute and convalescent asthmatic diseases (asthmatic group) were examined by competitive enzyme-linked immunosorbent assay (ELISA), excluding airway obstruction, asthma caused by airway foreign body and cardiac source, and 20 infants (non-asthmatic) in acute and convalescent period. Serum IL-4, IFN-gamma and urinary LTE4 levels were not significantly different among the three groups in age and sex. No hormone drugs or leukotriene modulators were used in the first four weeks of the study. Serum levels of IL-4, IFN-gamma and urinary LTE4 in the asthmatic group, the non-asthmatic group and the normal control group were collected. Blood and urine specimens were collected and frozen after centrifugation. The results were analyzed by SPSS 13.0 software.
Result:
1. Comparison of serum IL-4 levels in each group: The serum IL-4 levels in the acute stage of asthma group were significantly higher than those in the non-asthmatic group and the normal control group (P < 0.01), and the serum IL-4 levels in the convalescent stage (clinical remission stage) were significantly lower than those in the acute stage (P < 0.01), and there was no significant difference between the convalescent stage and the non-asthmatic group (P > 0.01). .05), but still higher than the normal control group (P < 0.01), with statistical significance.
2. Comparison of serum IFN-gamma levels in each group: The serum IFN-gamma levels in the asthmatic group were significantly lower than those in the non-asthmatic group in the acute phase and the normal control group (P < 0.01), and the serum IFN-gamma levels in the convalescent phase were significantly higher than those in the acute phase (P < 0.01), but still lower than those in the non-asthmatic group in the convalescent phase and the normal control group (P < 0.01).
3. Comparison of serum IL-4/IFN-gamma ratio in each group: The serum IL-4/IFN-gamma ratio in acute stage of asthma group was significantly higher than that in non-asthmatic group and normal control group (F = 15.86, P < 0.01); the serum IL-4/IFN-gamma ratio in convalescent stage was significantly lower than that in acute stage (t = 4.14, P < 0.01), but still higher than that in convalescent stage and normal control group. Academic differences (F=19.98, P < 0.01).
4. Comparison of urinary LTE4 levels in each group: Urinary LTE4 levels in the asthmatic group were significantly higher than those in the normal control group (P < 0.01), but there was no significant difference between the asthmatic group and the non-asthmatic group (P > 0.05). Group P (0.01) was statistically significant.
5. Correlation analysis of serum IL-4, IFN-gamma and urinary LTE4 levels: Serum IL-4 and urinary LTE4 were positively correlated in asthmatic group at acute stage (r = 0.823, P < 0.01); serum IFN-gamma and urinary LTE4 were negatively correlated in asthmatic group at acute stage (r =-0.806, P < 0.01).
Conclusion:
1. The serum levels of IL-4 in the asthmatic group were higher than those in the non-asthmatic group and the normal control group, and decreased with the remission of the disease, but the remission period was still higher than that in the non-asthmatic group and the normal control group, suggesting that IL-4 participated in the acute attack of asthmatic disease and chronic persistent inflammatory reaction.
2. The level of serum IFN-gamma in asthmatic infants was lower than that in non-asthmatic infants. In normal control group, the level of serum IFN-gamma increased after remission, but it was still lower than that in non-asthmatic infants and normal infants, suggesting that IFN-gamma also participated in the onset of asthma.
3. The serum levels of IL-4/IFN-gamma in the acute stage of wheezing infants were significantly higher than those in the non-wheezing infants and the normal control group, and decreased with the remission of the disease, but the remission period was still higher than that in the non-wheezing infants and the normal control group. Provide theoretical basis.
4. Urinary LTE4 levels in the asthmatic group were higher than those in the non-asthmatic group and the normal control group, and decreased with the remission of the disease, but the remission period was still higher than that in the non-asthmatic group and the normal control group, suggesting that CysLTs participated in the acute attack of asthmatic diseases and chronic persistent inflammatory reaction.
5. There was a significant positive correlation between serum IL-4 level and urinary LTE4 level in children with asthma at acute attack stage, and a significant negative correlation between serum IFN-gamma and urinary LTE4 level, suggesting that IL-4, IFN-gamma and CysLTs may participate in the acute attack of asthmatic diseases, and the relationship between them may promote and inhibit the occurrence and development of asthma.
6. The levels of serum IL-4, urinary LTE4 and IFN-gamma in children with wheezing were continuously elevated, and the imbalance of Th1/Th2 immunity may be one of the important causes of wheezing in infants. It provides a theoretical basis for clinical immune intervention, adjusting the imbalance of Th1/Th2 immunity, and using leukotriene receptor antagonists to treat wheezing diseases in infants.
【學(xué)位授予單位】：南昌大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R725.6
本文編號(hào)：2216191
[Abstract]:Objective:
To investigate the role of serum interleukin-4 (IL-4), interferon-gamma (IFN-gamma) and urinary leukotriene (LTE4) in the development of infantile wheezing diseases, and to explore the possible relationship between serum IL-4, IFN-gamma and urinary LTE4 in the development of infantile wheezing diseases. Pathogenesis provides a theoretical basis for clinical treatment of wheezing diseases in infants.
Method:
From January 2011 to December 2011, 22 infants (3 years old) with acute and convalescent asthmatic diseases (asthmatic group) were examined by competitive enzyme-linked immunosorbent assay (ELISA), excluding airway obstruction, asthma caused by airway foreign body and cardiac source, and 20 infants (non-asthmatic) in acute and convalescent period. Serum IL-4, IFN-gamma and urinary LTE4 levels were not significantly different among the three groups in age and sex. No hormone drugs or leukotriene modulators were used in the first four weeks of the study. Serum levels of IL-4, IFN-gamma and urinary LTE4 in the asthmatic group, the non-asthmatic group and the normal control group were collected. Blood and urine specimens were collected and frozen after centrifugation. The results were analyzed by SPSS 13.0 software.
Result:
1. Comparison of serum IL-4 levels in each group: The serum IL-4 levels in the acute stage of asthma group were significantly higher than those in the non-asthmatic group and the normal control group (P < 0.01), and the serum IL-4 levels in the convalescent stage (clinical remission stage) were significantly lower than those in the acute stage (P < 0.01), and there was no significant difference between the convalescent stage and the non-asthmatic group (P > 0.01). .05), but still higher than the normal control group (P < 0.01), with statistical significance.
2. Comparison of serum IFN-gamma levels in each group: The serum IFN-gamma levels in the asthmatic group were significantly lower than those in the non-asthmatic group in the acute phase and the normal control group (P < 0.01), and the serum IFN-gamma levels in the convalescent phase were significantly higher than those in the acute phase (P < 0.01), but still lower than those in the non-asthmatic group in the convalescent phase and the normal control group (P < 0.01).
3. Comparison of serum IL-4/IFN-gamma ratio in each group: The serum IL-4/IFN-gamma ratio in acute stage of asthma group was significantly higher than that in non-asthmatic group and normal control group (F = 15.86, P < 0.01); the serum IL-4/IFN-gamma ratio in convalescent stage was significantly lower than that in acute stage (t = 4.14, P < 0.01), but still higher than that in convalescent stage and normal control group. Academic differences (F=19.98, P < 0.01).
4. Comparison of urinary LTE4 levels in each group: Urinary LTE4 levels in the asthmatic group were significantly higher than those in the normal control group (P < 0.01), but there was no significant difference between the asthmatic group and the non-asthmatic group (P > 0.05). Group P (0.01) was statistically significant.
5. Correlation analysis of serum IL-4, IFN-gamma and urinary LTE4 levels: Serum IL-4 and urinary LTE4 were positively correlated in asthmatic group at acute stage (r = 0.823, P < 0.01); serum IFN-gamma and urinary LTE4 were negatively correlated in asthmatic group at acute stage (r =-0.806, P < 0.01).
Conclusion:
1. The serum levels of IL-4 in the asthmatic group were higher than those in the non-asthmatic group and the normal control group, and decreased with the remission of the disease, but the remission period was still higher than that in the non-asthmatic group and the normal control group, suggesting that IL-4 participated in the acute attack of asthmatic disease and chronic persistent inflammatory reaction.
2. The level of serum IFN-gamma in asthmatic infants was lower than that in non-asthmatic infants. In normal control group, the level of serum IFN-gamma increased after remission, but it was still lower than that in non-asthmatic infants and normal infants, suggesting that IFN-gamma also participated in the onset of asthma.
3. The serum levels of IL-4/IFN-gamma in the acute stage of wheezing infants were significantly higher than those in the non-wheezing infants and the normal control group, and decreased with the remission of the disease, but the remission period was still higher than that in the non-wheezing infants and the normal control group. Provide theoretical basis.
4. Urinary LTE4 levels in the asthmatic group were higher than those in the non-asthmatic group and the normal control group, and decreased with the remission of the disease, but the remission period was still higher than that in the non-asthmatic group and the normal control group, suggesting that CysLTs participated in the acute attack of asthmatic diseases and chronic persistent inflammatory reaction.
5. There was a significant positive correlation between serum IL-4 level and urinary LTE4 level in children with asthma at acute attack stage, and a significant negative correlation between serum IFN-gamma and urinary LTE4 level, suggesting that IL-4, IFN-gamma and CysLTs may participate in the acute attack of asthmatic diseases, and the relationship between them may promote and inhibit the occurrence and development of asthma.
6. The levels of serum IL-4, urinary LTE4 and IFN-gamma in children with wheezing were continuously elevated, and the imbalance of Th1/Th2 immunity may be one of the important causes of wheezing in infants. It provides a theoretical basis for clinical immune intervention, adjusting the imbalance of Th1/Th2 immunity, and using leukotriene receptor antagonists to treat wheezing diseases in infants.
【學(xué)位授予單位】：南昌大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R725.6
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