支气管哮喘与慢性荨麻疹黏膜免疫介质相关性研究  

Humoral and haemal mucosal immunotransmitters in patients co-infected with bronchial asthma and chronic urticaria

作　　者：李风森[1] 张艳丽[1] 徐丹[1] 苏军[1] 王惠妩[2] 向阳冰[3] 孙奇 

机构地区：[1]新疆医科大学附属中医医院新疆·国家中医临床研究基地,乌鲁木齐830000 [2]新疆医科大学第一附属医院呼吸科,乌鲁木齐830000 [3]新疆医科大学第一附属医院变态反应室,乌鲁木齐830000 [4]新疆维吾尔自治区中医医院医学研究设计与数据处理中心,乌鲁木齐830000

出　　处：《中国实用内科杂志》2013年第8期639-643,共5页Chinese Journal of Practical Internal Medicine

基　　金：新疆维吾尔自治区自然科学基金(2009211A21)

摘　　要：目的探讨支气管哮喘(简称哮喘)和慢性荨麻疹发病过程中黏膜免疫介质上的相关性。方法收集2009年1月至2010年9月在新疆医科大学附属中医医院门诊就诊的哮喘患者71例(A组),哮喘合并慢性荨麻疹患者33例(B组),单纯慢性荨麻疹患者31例(C组)以及正常人30名(D组)。ELISA法检测入选者痰、唾液及鼻分泌液中分泌性免疫球蛋白A(sIgA)、血清总免疫球蛋白E(T-IgE)及嗜酸阳离子蛋白(ECP);流式细胞仪检测血液中CD4+、CD8+T淋巴细胞。结果 (1)A、B、C组唾液中sIgA含量均较D组明显升高(P<0.01);组间比较差异均无统计学意义(P>0.05);C组较B组升高(P<0.01)。A、B、C组鼻腔分泌液中sIgA含量较D组均明显升高(P<0.01),组间比较差异无统计学意义。A、B组痰液中sIgA含量均较C、D组低(P<0.01),C、D组差异无统计学意义(P>0.05)。(2)A、B、C组血液中CD4+、CD4+/CD8+、T-IgE、ECP的表达较D组均升高(P<0.01),组间比较差异无统计学意义(P>0.05);4组样本血液中CD8+的比较差异无统计学意义(P>0.05)。(3)除D组唾液与痰液中sIgA含量呈负相关(r=-0.369,P=0.045)外,其余3组各分泌物中sIgA的含量之间均无相关性。(4)除A组血液中IgE与ECP水平略呈正相关(r=0.392,P=0.002)外,其余各组中T-IgE与ECP水平无相关性。结论 CD4+、CD8+、sIgA、T-IgE及ECP在支气管哮喘和慢性荨麻疹患者中有着共同体现,黏膜免疫相关介质可能是二者之间联系的物质基础,哮喘和荨麻疹可能是共同的病理特征在不同部位的体现。Objective To investigate the common pathology and mucosal immune connection between bronchial asthma and chronic urticaria through determination of secretory immunoglobulin-A （sIgA） in the saliva, sputum and nasal secretions as well as CD4 ＋ ,CD8＋ T lymphocyte, eosinophil cationic protein（ECP） and immunoglobulin E（T-IgE） in the blood of patients co-infected with bronchial asthma and chronic urticaria. Methods One hundred and sixty-five subjects were divided into 4 groups according to their diagnoses ： Asthma Group （ n=71 ） ; Urticaria Group （ n = 31 ） ; Combined Group （ n = 33 ; with bronchial asthma and chronic urticaria） ; and Control Group（ n = 30）. sIgA in the sputum, saliva, nasal secretion and T-IgE, ECP in the blood were determined using ELISA ; CD4 ＋ and CD8 ＋ T lymphocytes in the blood were measured using flow cytometry. Results （ 1 ） sIgA in saliva and nasal secretion were higher in Asthma, Urticaria, and Combined Groups than in Control group（P 〈 0. 05） ;sIgA in saliva of the urticaria group was increased compared with that of the Combined Group（ P 〈 0.05 ） , but compared among the three groups of patients, sIgA in nasal secretion was not statistically significant （P 〉 0. 05 ）. sIgA in sputum was lower in Asthma and Combined groups than in Control group and Urticaria Group （P 〈 0. 05） ;comparison between the urticaria group and the normal group had no difference （ P 〉 0. 05 ）. （2） CD4 ＋ ,CD4 ＋/CD8＋ , T-IgE and ECP were higher in Asthma Group, Urticaria Group, and Combined Group than in Control Group （P 〈 0. 05 ）, but the comparison among the three groups of patients was not statistically significant（P 〉0.05）. There was no difference in CD8＋ levels among four groups （ P 〈 0. 05 ）. （ 3 ） Except the sIgA content in saliva and sputum of the normal group, which showed negative correlation （ r = - 0. 369, P = 0. 045 ）, the sIgA distribution in secretion of samples of the other three groups had no corr

关 键 词：支气管哮喘 慢性荨麻疹 黏膜免疫 分泌性免疫球蛋白A 嗜酸阳离子蛋白 

分 类 号：R562.25[医药卫生—呼吸系统]