免疫调节剂对哮喘患儿血清IL-4及IFN-γ的影响及临床疗效分析  

Effect and Analysis of Clinical Efficacy of Immunomodulator on Serum Levels of IL-4 and IFN-γ in Asthmatic Children

作　　者：陈壮桂[1] 纪经智[1] 李鸣[2] 陈伟[1] 陈岩峰[1] 陈奋华[1] 陈虹[1] 

机构地区：[1]中山大学附属第三医院儿科,广东广州510630 [2]中山大学附属第一医院黄埔院区呼吸内科,广东广州510700

出　　处：《中山大学学报（医学科学版）》2009年第1期100-103,共4页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：广东省科技计划项目(2007B030700003)

摘　　要：【目的】探讨免疫调节剂对哮喘儿童血清Th1/Th2细胞因子的影响及临床疗效。【方法】选择哮喘急性发作期儿童患者45例,分为两组:治疗组29例,服泛福舒(BV)。对照组16例,给予相对应级别剂量的糖皮质激素吸入治疗。入选患儿随访1年。所有患儿在治疗前及12个月后检测血清IL-4、IFN-γ、血浆总IgE浓度,测定肺功能。【结果】治疗组因哮喘发作需急诊就诊的次数为(1.02±0.92)次,呼吸道感染的次数(1.32±1.03)次,而对照组分别为(2.17±1.52)和(3.78±1.81)次,两组差异有统计学意义(P<0.05);两组患儿呼吸道感染频率和哮喘再发次数正相关(P<0.01)。治疗后,两组IgE水平无明显下降。治疗组血清IL-4水平无明显改变,IFN-γ水平明显升高,对照组血清IL-4水平下降,IFN-γ水平升高;两组IFN-γ/IL-4比值较治疗前均明显升高,差异有统计学意义(P<0.05);两组组间比较:治疗前后,两组IFN-γ/IL-4比值比较,差异无统计学意义(P>0.05)。治疗后治疗组患儿肺功能指标明显优于对照组(P<0.05)。【结论】BV不仅增强呼吸道特异性及非特异性的免疫防御功能,降低诱发哮喘发作的危险因素;而且能够纠正机体Th1/Th2类细胞表达的偏移,调整哮喘患儿的免疫异常。[Objective] To investigate the effect and clinical efficacy of immunomodulator on serum Th1/Th2 cytokines in asthmatic children. [Methods] Forty-five children of asthma at acute stage were enrolled and divided into two groups. Twenty-nine eases took bacterial lysates （Broncho-Vaxom, BV） in treatment group/BV group. Sixteen cases were given the same amount of inhaled corticosteroids （ICS） for treatment in control group/ICS group. Blood samples of all patients were drawn before and 12 months after treatment to detect the serum IL-4 and IFN-γ and total plasma IgE levels, and their lung functions were measured as well. All of them were followed up for one year. [Results] The frequencies of emergency visiting for asthma attack and respiratory tract infection in treatment group were （1.32 ± 1.03 ） and （1.32 ± 1.03 ） respectively, while in control group the frequencies were （2.17 ± 1.52） and （3.78 ± 1.81 ） respectively. The differences between the two groups had statistical significance （P 〈 0.05）. The frequencies of respiratory tract infection were positively correlated with that of asthma relapse in both groups （P 〈 0.01 ）. IgE levels did not decrease obviously in both groups after treatment. Serum level of IL-4 did not change but IFN-＇y increased obviously in treatment group. In control group, serum level of IL-4 decreased and IFN-γ increased. The ratios of IFN-γ IL-4 in both groups increased obviously compared with that before treatment and the differences had statistical significance （P 〈 0.05）. The ratios of IFN-γ IL-4 before and after treatment in both groups had no statistical significances （P 〉 0.05）. The lung function index in treatment group was better than that in control group （P 〈 0.05）. [Conclusions] Broncho-Vaxom not only enhances the specific and non-specific immune defense function of respiratory tract, reduces the risk factors of inducing asthma, corrects the expression migration of Th1/Th2 type cytokines, but also regulates the immune ab

关 键 词：免疫调节剂 支气管哮喘 细胞因子 儿童 

分 类 号：R725.6[医药卫生—儿科]