兒童肺炎支原體肺炎血清中細(xì)胞因子含量變化及其對(duì)氣管張力的影響
發(fā)布時(shí)間：2018-10-26 07:17
【摘要】：目的:調(diào)查病情嚴(yán)重程度不同MPP患者血清中細(xì)胞因子(IL-8、18、10)含量的變化及其相應(yīng)的臨床炎癥指標(biāo)(CRP、LDH)之間的相關(guān)性,探討炎癥因子在MPP、尤其SMPP發(fā)病中作用。方法:募集自2013年3月~2015年2月安徽醫(yī)科大學(xué)第一附屬醫(yī)院兒科門診及同期呼吸病房共66例兒童為研究對(duì)象,對(duì)照組32例(健康兒童),實(shí)驗(yàn)組34例(兒童MPP患者)。其中實(shí)驗(yàn)組又分為輕癥MPP無(wú)合并哮喘組(Group 1);重癥MPP無(wú)合并哮喘組(Group 2);輕癥MPP合并哮喘組(Group 3),檢測(cè)兩組、實(shí)驗(yàn)組內(nèi)細(xì)胞因子含量及相應(yīng)炎癥指標(biāo)。同時(shí)收集臨床資料包括:性別、年齡、LDH、CRP、血常規(guī)(淋巴細(xì)胞、中性粒細(xì)胞)等,比較分析對(duì)照組與實(shí)驗(yàn)組以及實(shí)驗(yàn)組間血清樣本中細(xì)胞因子含量變化及相應(yīng)臨床炎癥指標(biāo)之間的相關(guān)性,用ELISA法測(cè)定細(xì)胞因子水平。結(jié)果:(1)與對(duì)照組比較,實(shí)驗(yàn)組血清細(xì)胞因子(IL-8、IL-10、IL-18)水平顯著升高,差異有統(tǒng)計(jì)學(xué)意義(P=0.044、0.001、0.001)。(2)與治療前比較,實(shí)驗(yàn)組血清中細(xì)胞因子IL-18和CRP在治療后下降,差異有統(tǒng)計(jì)學(xué)意義(P=0.020和0.001)。(3)與Group1比較,Group 2細(xì)胞因子IL-8水平增高,差異無(wú)統(tǒng)計(jì)學(xué)意義(P=0.232);與Group1比較,Group 2細(xì)胞因子IL-18水平增高,差異具有統(tǒng)計(jì)學(xué)意義(P0.05);與Group1比較,Group 2細(xì)胞因子IL-10水平降低,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。(4)細(xì)胞因子與CRP之間的相關(guān)性:IL-8和IL-18與CRP有正相關(guān)性,(R=0.467和0.619,P0.001,0.05)。IL-10與CRP之間無(wú)相關(guān)性(R=0.223,P=0.058)。結(jié)論:細(xì)胞因子IL-8、IL-18和IL-10參與MPP中炎癥反應(yīng),IL-10在MPP發(fā)病炎癥中發(fā)揮雙向調(diào)節(jié)作用,IL-10水平可作為MPP嚴(yán)重炎癥預(yù)測(cè)指標(biāo)之一,控制炎癥在MPP尤其SMPP治療中至關(guān)重要。目的:本研究擬通過(guò)動(dòng)物實(shí)驗(yàn)闡明TNF-α或IL-8在激動(dòng)劑引起的小鼠氣管平滑肌收縮中的效應(yīng),進(jìn)一步驗(yàn)證細(xì)胞因子在MPP發(fā)病中作用機(jī)制。方法:實(shí)驗(yàn)采用小鼠氣管離體培養(yǎng),通過(guò)TNF-α或IL-8孵育小鼠氣管18小時(shí)后,利用張力測(cè)定系統(tǒng)檢測(cè)激動(dòng)劑引起的氣管平滑肌張力的變化,旨在揭示TNF-α和IL-8對(duì)小鼠氣管平滑肌VDCC介導(dǎo)的鈣內(nèi)流的影響,并進(jìn)一步探討VDCC蛋白表達(dá)水平變化及其對(duì)氣管張力的影響。結(jié)果:通過(guò)研究發(fā)現(xiàn):(1)TNF-α和IL-8預(yù)處理可以顯著增強(qiáng)高鉀和卡巴膽堿引起的小鼠氣管收縮性;(2)VDCC通道阻斷劑可以顯著阻斷TNF-α和IL-8預(yù)處理引起的小鼠氣管收縮增強(qiáng)作用;(3)蛋白免疫印跡實(shí)驗(yàn)發(fā)現(xiàn),TNF-α和IL-8預(yù)處理顯著增強(qiáng)了小鼠氣管VDCC的表達(dá)。結(jié)論:炎癥因子可通過(guò)增強(qiáng)氣管平滑肌細(xì)胞VDCC的表達(dá),增強(qiáng)其對(duì)收縮劑的收縮反應(yīng),從而可能導(dǎo)致氣管痙攣和呼吸功能障礙。該研究有助于了解炎癥因子在MPP發(fā)病中的可能作用和機(jī)制,為將來(lái)的治療提供一定的理論依據(jù),為臨床治療提供潛在的、新的治療方法。
[Abstract]:Objective: to investigate the changes of serum cytokine (IL-8,18,10) levels in patients with MPP with different severity of disease and the correlation between the corresponding clinical inflammatory markers (CRP,LDH), and to explore the role of inflammatory factors in the pathogenesis of MPP, especially SMPP. Methods: from March 2013 to February 2015, 66 children in pediatrics outpatient department and respiratory ward of the first affiliated Hospital of Anhui Medical University were recruited, 32 healthy children in control group and 34 MPP patients in experimental group. The experimental group was divided into three groups: mild MPP without asthma (Group 1), severe MPP without asthma (Group 2) and mild MPP with asthma (Group 3). Clinical data including sex, age, LDH,CRP, blood test (lymphocytes, neutrophils) were also collected. The levels of cytokines in serum samples of the control group, the experimental group and the corresponding clinical inflammatory indexes were compared and analyzed. The levels of cytokines were measured by ELISA method. Results: (1) compared with the control group, the level of serum cytokine (IL-8,IL-10,IL-18) in the experimental group was significantly higher than that in the control group (P < 0.04 鹵0.001 / 0. 001). (2). The levels of serum cytokines IL-18 and CRP in the experimental group were significantly decreased after treatment (P0. 020 and 0.001). (3). Compared with Group1, the level of Group 2 cytokine IL-8 was increased, but there was no significant difference (P0. 232). Compared with Group1, the level of Group 2 cytokine IL-18 increased, the difference was statistically significant (P0.05). Compared with Group1, the level of Group 2 cytokine IL-10 was significantly lower than that of Group1 (P0.05). (4) the correlation between cytokines and CRP: IL-8 and IL-18 were positively correlated with CRP (RP0. 467 and 0. 619, P < 0. 05). There was no correlation between IL-10 and CRP. Conclusion: cytokines IL-8,IL-18 and IL-10 are involved in the inflammatory reaction in MPP, and IL-10 plays a bidirectional role in the pathogenesis of MPP. IL-10 level can be used as one of the predictors of severe inflammation of MPP. Controlling inflammation is essential in MPP, especially in the treatment of SMPP. Aim: to elucidate the effects of TNF- 偽 or IL-8 on the contraction of tracheal smooth muscle in mice induced by agonists in order to further verify the role of cytokines in the pathogenesis of MPP. Methods: the mouse trachea was cultured in vitro and incubated with TNF- 偽 or IL-8 for 18 hours. The tension of tracheal smooth muscle induced by agonist was measured by tension measurement system. The aim of this study was to investigate the effects of TNF- 偽 and IL-8 on the calcium influx mediated by VDCC in the tracheal smooth muscle of mice, and to further explore the changes of VDCC protein expression and its effect on tracheal tension. Results: (1) TNF- 偽 and IL-8 pretreatment could significantly enhance tracheal contraction induced by high potassium and carbachol in mice. (2) VDCC channel blockers could significantly block the enhancement of tracheal contraction induced by TNF- 偽 and IL-8 pretreatment in mice. (3) Western blot analysis showed that TNF- 偽 and IL-8 pretreatment significantly enhanced the expression of VDCC in the trachea of mice. Conclusion: inflammatory factors may enhance the contractile response of tracheal smooth muscle cells by enhancing the expression of VDCC, which may lead to tracheal spasm and respiratory dysfunction. This study is helpful to understand the possible role and mechanism of inflammatory factors in the pathogenesis of MPP, to provide some theoretical basis for future treatment, and to provide potential and new treatment methods for clinical treatment.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2016
【分類號(hào)】：R725.6
本文編號(hào)：2294979
[Abstract]:Objective: to investigate the changes of serum cytokine (IL-8,18,10) levels in patients with MPP with different severity of disease and the correlation between the corresponding clinical inflammatory markers (CRP,LDH), and to explore the role of inflammatory factors in the pathogenesis of MPP, especially SMPP. Methods: from March 2013 to February 2015, 66 children in pediatrics outpatient department and respiratory ward of the first affiliated Hospital of Anhui Medical University were recruited, 32 healthy children in control group and 34 MPP patients in experimental group. The experimental group was divided into three groups: mild MPP without asthma (Group 1), severe MPP without asthma (Group 2) and mild MPP with asthma (Group 3). Clinical data including sex, age, LDH,CRP, blood test (lymphocytes, neutrophils) were also collected. The levels of cytokines in serum samples of the control group, the experimental group and the corresponding clinical inflammatory indexes were compared and analyzed. The levels of cytokines were measured by ELISA method. Results: (1) compared with the control group, the level of serum cytokine (IL-8,IL-10,IL-18) in the experimental group was significantly higher than that in the control group (P < 0.04 鹵0.001 / 0. 001). (2). The levels of serum cytokines IL-18 and CRP in the experimental group were significantly decreased after treatment (P0. 020 and 0.001). (3). Compared with Group1, the level of Group 2 cytokine IL-8 was increased, but there was no significant difference (P0. 232). Compared with Group1, the level of Group 2 cytokine IL-18 increased, the difference was statistically significant (P0.05). Compared with Group1, the level of Group 2 cytokine IL-10 was significantly lower than that of Group1 (P0.05). (4) the correlation between cytokines and CRP: IL-8 and IL-18 were positively correlated with CRP (RP0. 467 and 0. 619, P < 0. 05). There was no correlation between IL-10 and CRP. Conclusion: cytokines IL-8,IL-18 and IL-10 are involved in the inflammatory reaction in MPP, and IL-10 plays a bidirectional role in the pathogenesis of MPP. IL-10 level can be used as one of the predictors of severe inflammation of MPP. Controlling inflammation is essential in MPP, especially in the treatment of SMPP. Aim: to elucidate the effects of TNF- 偽 or IL-8 on the contraction of tracheal smooth muscle in mice induced by agonists in order to further verify the role of cytokines in the pathogenesis of MPP. Methods: the mouse trachea was cultured in vitro and incubated with TNF- 偽 or IL-8 for 18 hours. The tension of tracheal smooth muscle induced by agonist was measured by tension measurement system. The aim of this study was to investigate the effects of TNF- 偽 and IL-8 on the calcium influx mediated by VDCC in the tracheal smooth muscle of mice, and to further explore the changes of VDCC protein expression and its effect on tracheal tension. Results: (1) TNF- 偽 and IL-8 pretreatment could significantly enhance tracheal contraction induced by high potassium and carbachol in mice. (2) VDCC channel blockers could significantly block the enhancement of tracheal contraction induced by TNF- 偽 and IL-8 pretreatment in mice. (3) Western blot analysis showed that TNF- 偽 and IL-8 pretreatment significantly enhanced the expression of VDCC in the trachea of mice. Conclusion: inflammatory factors may enhance the contractile response of tracheal smooth muscle cells by enhancing the expression of VDCC, which may lead to tracheal spasm and respiratory dysfunction. This study is helpful to understand the possible role and mechanism of inflammatory factors in the pathogenesis of MPP, to provide some theoretical basis for future treatment, and to provide potential and new treatment methods for clinical treatment.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2016
【分類號(hào)】：R725.6
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