本文選題：粉塵螨 + 舌下特異性免疫治療�。� 參考：《南昌大學(xué)》2011年碩士論文

【摘要】：目的：通過比較舌下特異性免疫治療(sublingual specific immunotherapy, SLIT)前后血清白介素-17(IL-17)、白介素-10(IL-10)、特異性IgE (specific IgE, SIgE)、特異性IgG4 (specific IgG4, SIgG4)的水平變化,探討抑炎因子IL-10及促炎因子IL-17在SLIT中的作用及SLIT可能的作用機制；評價SLIT的安全性及有效性。 方法：選擇年滿4-14周歲,對粉塵螨過敏的過敏性鼻炎和／或輕度哮喘患兒30例作為病例組,采用粉塵螨滴劑進行SLIT24周；另選取年滿4-14周歲的健康兒童25例作為正常對照組。應(yīng)用雙抗體夾心酶聯(lián)免疫吸附試驗(Enzyme-linked immunosorbent assay,ELISA)分析法分別檢測血清IL-17、IL-10、SIgE、SIgG4。分別比較病例組治療前、治療24周后及正常對照組上述各項指標(biāo)的變化；同時對病例組治療前后還進行外周血嗜酸性粒細胞(eosinophil, Eos)計數(shù)、肺功能／氣道阻力的測定以及鼻炎和／或哮喘癥狀評分及癥狀總評分。 結(jié)果：經(jīng)過24周SLIT后,患兒血清IL-17水平較治療前明顯下降,P0.01,但較正常對照組仍高,P＜0.01；血清IL-10水平較治療前明顯升高,P0.01,但仍低于正常對照組,P0.0l；血清SIgE水平較治療前有所下降,P＞0.05,無統(tǒng)計學(xué)意義;血清SIgG4水平明顯升高,P＜0.01,差異有顯著統(tǒng)計學(xué)意義；外周血嗜酸性粒細胞計數(shù)較治療前明顯下降,P＜0.01,差異有顯著統(tǒng)計學(xué)意義；肺功能,第一秒用力呼氣容積(FEV1%：實測值／預(yù)計值)較治療前升高,氣道阻力(%：實測值／預(yù)計值)則較治療前下降,P0.05,差異有統(tǒng)計學(xué)意義；且所有患兒的鼻炎和／或哮喘癥狀評分及癥狀總評分較治療前均有下降,P0.0l,差異有顯著統(tǒng)計學(xué)意義。治療效果：顯效43.3%、有效50%、無效6.7%；病例組患兒的鼻炎和／或哮喘癥狀均得到顯著改善。病例組在進行SLIT前及治療24周后,血清IL-10與血清SIgG4水平均成正相關(guān)關(guān)系,且與患兒癥狀總評分均成負相關(guān)關(guān)系；SIgG4與癥狀總評分存在負相關(guān)關(guān)系。 結(jié)論：(1)促炎因子IL-17是兒童呼吸道變應(yīng)性疾病的一個重要致病因子。SLIT可以降低血清中促炎因子IL-17的水平,提高抑炎因子IL-10的水平。(2)證實SIgG4在兒童呼吸道變應(yīng)性疾病中起保護性抗體作用。(3)SLIT是兒童呼吸道變應(yīng)性疾病的一種安全、有效的治療方法,但目前多種過敏原SLIT暫不推薦廣泛應(yīng)用。
[Abstract]:Objective: to compare the serum levels of interleukin-17 (IL-17), interleukin-10 (IL-10), specific IgE (Siga), specific IgG4 (SIgG4) before and after sublingual specific immunotherapy (SLITT). To investigate the role of anti-inflammatory factor IL-10 and pro-inflammatory factor IL-17 in SLIT and the possible mechanism of SLIT, to evaluate the safety and efficacy of SLIT. Methods: thirty cases of allergic rhinitis and / or mild asthma with allergic rhinitis and / or mild asthma aged 4-14 years were selected as the case group, and 25 healthy children aged 4-14 years were selected as the normal control group. Double antibody sandwich enzyme-linked immunosorbent assay (Elisa) was used to detect serum IL-17, IL-10, Siga, Siga and Siga. The changes of the above indexes were compared before treatment, 24 weeks after treatment and in the normal control group, and the eosinophilic (eosinophilic) counts of peripheral blood were also counted before and after treatment in the case group. Measurement of pulmonary function / airway resistance, as well as rhinitis and / or asthma symptom score and total symptom score. Results: after 24 weeks of SLIT, the serum IL-17 level was significantly lower than that before treatment, but still higher than that of the normal control group (P < 0.01), and the serum IL-10 level was significantly higher than that of the control group (P 0.01), but still lower than that of the normal control group (P 0.0l). The level of Siga E in serum was lower than that before treatment (P > 0.05), but the level of Siga _ 4 in serum was significantly higher than that before treatment (P < 0.01). The eosinophil count in peripheral blood was significantly lower than that before treatment (P < 0.01), and the pulmonary function, forced expiratory volume in the first second (FEV1: actual value / predicted value) was higher than that before treatment, and the number of eosinophils in peripheral blood was significantly lower than that before treatment (P < 0.01). The score of the symptoms of rhinitis and / or asthma and the total score of symptoms in all the children were significantly lower than that before treatment (P 0.0l). The results showed that the symptoms of rhinitis and / or asthma were significantly improved in the case group. There was a positive correlation between serum IL-10 and Siga _ 4 level before SLIT and 24 weeks after treatment, and there was a negative correlation between serum IL-10 and Siga _ 4, and there was a negative correlation between Siga _ 4 and total symptom score. Conclusion Interleukin-17 (IL-17) is an important pathogenic factor of respiratory allergic disease in children. SLIT can reduce the level of IL-17 in serum. It is proved that Siga _ 4 plays a protective role in children's respiratory allergic diseases. It is a safe and effective method to treat children's respiratory allergic diseases. However, currently many allergens SLIT is not recommended to be widely used.
【學(xué)位授予單位】：南昌大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2011
【分類號】：R725.6;R765.21

【參考文獻】

相關(guān)期刊論文 前10條

1 黃學(xué)勤;程學(xué)仕;王俊芳;楊洋;;粉塵螨滴劑治療變應(yīng)性鼻炎的臨床療效及安全性觀察[J];安徽醫(yī)藥;2010年06期

2 馬香萍;多力坤;;舌下特異性免疫治療對塵螨過敏性哮喘兒童的作用[J];中國當(dāng)代兒科雜志;2010年05期

3 楊紅葉;;兒童變態(tài)反應(yīng)疾病脫敏治療的依從性研究進展[J];護士進修雜志;2009年07期

4 唐碧霞;張p，

本文編號：2032005