毛细支气管炎患儿单核细胞Toll样受体-4的表达与维生素D水平变化的关系  

Relationship between the expression of Toll-like receptor 4 on mononuclear cells in peripheral blood and changes of serum vitamin D level in children with bronchiolitis

作　　者：吴奎[1] 袁北芳 侯学敬[2] 李超[1] 任立红[1] 

机构地区：[1]哈尔滨医科大学附属第二临床医院儿内科,150086 [2]哈尔滨医科大学附属第四医院儿科

出　　处：《中华实用儿科临床杂志》2015年第12期938-940,共3页Chinese Journal of Applied Clinical Pediatrics

摘　　要：目的 探讨毛细支气管炎患儿外周血中单核细胞Toll样受体-4（TLR4）的表达与血清维生素D水平变化的关系.方法 选取2013年10月至2014年1月在哈尔滨医科大学附属第二临床医院住院诊治的毛细支气管炎患儿为治疗前组,再根据病情分为轻中度和重度2组,每组20例;将治疗后好转的病例设为治疗后组,以同期在哈尔滨医科大学附属第二临床医院保健门诊体检的健康儿童30例为健康对照组.流式细胞术检测外周血中CD14标记的单核细胞表达的TLR4,酶联免疫吸附试验（ELISA）检测血清中25羟维生素D[25（OH）D]水平.结果 1.毛细支气管炎患儿治疗前单核细胞TLR4的表达水平：轻中度组[（18.98±2.29）％]、重度组[（30.13±2.13）％]较健康对照组[（1.17±0.57）％]显著增高（P＜0.05）;治疗后水平：轻中度组[（2.02±0.48）％]、重度组[（11.43 ±1.52）％]比治疗前下降（P＜0.05）.2.毛细支气管炎患儿治疗前血清维生素D水平：轻中度组[（17.16±3.34） μg/L]、重度组[（6.56±2.28） μg/L]较健康对照组[（53.69±20.18）μg/L]显著降低,而治疗前重度组[（6.56±2.28） μg/L]更低（P＜0.05）;治疗后维生素D水平：轻中度组[（9.59 ±2.31） μg/L]、重度组[（4.70±0.67） μg/L]比治疗前降低（P＜0.05）.3.毛细支气管炎患儿治疗前重度组（r=-0.491,P＜0.05）和治疗后轻中度组（r=-0.436,P＜0.05）外周血单核细胞表达TLR4与血清25 （OH）D水平呈负相关,而健康对照组、治疗前轻中度组及治疗后重度组无相关性（P＞0.05）.结论 毛细支气管炎患儿病情与TLR4表达水平呈正相关,与维生素D水平呈负相关,在治疗过程中血清25（OH）D持续下降.毛细支气管炎患儿单核细胞TLR4表达与维生素D水平具有一定的相关性.Objective To investigate the relationship between the expression of Toll-like receptor 4 （TLR4） on mononuclear cells in peripheral blood and changes of serum vitamin D level in children with bronchiolitis.Methods The children who were diagnosed as bronchiolitis and received treatment in the Second Affiliated Hospital of Harbin Medical University from October 2013 to January 2014 were chosen as the pre-treatment group,and then divided them into moderate group and severe group according to the clinical symptoms,20 cases for each group.Then the cases in pre-treatment group who recovered after treatment were recruited as the after-treatment group,and the children who were healthy and medical examination in the Second Affiliated Hospital of Harbin Medical University in the same period were recruited as the healthy control group.The expressions of TLR4 on CD14 labeled mononuclear cells in the periphera were measured by flow cytometry.The level of 25 （OH） D in serum was detected by enzyme linked immunosorbent assay （ELISA）.Results （1） The expression level in children with bronchiolitis of TLR4：the mode-rate group [（18.98 ±2.29）%] and severe group [（30.13 ±2.13）%] increased significantly （P 〈0.05） compared with control group [（1.17 ± 0.57） %].And the expression level of moderate group [（2.02 ± 0.48） %] and severe group [（11.43 ± 1.52） %] decreased significantly after treatment （P 〈0.05）.（2） Serum vitamin D level in children with bronchiolitis of the moderate group[（17.16 ± 3.34） μg/L] and severe group [（6.56 ±2.28） μg/L] were lower than healthy control group [（53.69 ±20.18） μg/L] before treatment （P 〈 0.05）,especially the severe group [（6.56 ±2.28） μg/L].The level of moderate group [（9.59 ±2.31） μg/L] and severe group [（4.70 ±0.67） μg/L] became lower after treatment （P 〈 0.05）.（3） Both severe group （r =-0.491,P 〈 0.05） before treatment and moderate group （r =-0.436,P 〈 0.05） after treatment showed ne

关 键 词：毛细支气管炎 维生素D 25羟维生素D TOLL样受体-4 喘息 

分 类 号：R725.6[医药卫生—儿科]