骨化三醇对肺炎支原体肺炎患儿Th17/Treg失衡的干预作用  

Intervention Effect of Calcitriol on Th17/Treg Imbalance in Children with Mycoplasma Pneumoniae Pneumonia

作　　者：曹正 余蓉[2] 薛冰[2] 王建荣[2] Cao Zheng;Yu Rong;Xue Bing(Graduate School,Xinjiang Medical University,Xinjiang 830011,China)

机构地区：[1]新疆医科大学研究生院,乌鲁木齐830011 [2]新疆医科大学第五附属医院儿科,乌鲁木齐830011

出　　处：《医学研究杂志》2019年第12期111-114,共4页Journal of Medical Research

基　　金：新疆医科大学科研创新基金资助项目(XYDCX2016100)

摘　　要：目的探讨骨化三醇[1,25(OH)2D 3]对肺炎支原体肺炎(mycoplasma pneumonia pneumonia,MPP)患儿Th17/Treg及相关因子表达的调节作用。方法选取2018年9~12月在新疆医科大学第五附属医院儿科就诊的50例MPP患儿为实验组,并取健康儿童50例为对照组,酶联免疫分析法(ELISA法)检测血清中1,25(OH)2D 3、IL-10及IL-17的含量,流式细胞分析技术检测Th17及Treg水平。将实验组随机分为维生素D干预组、非维生素D干预组各25例,维生素D干预组儿童在常规治疗基础上口服维生素D,2周后再次检测两组患儿外周血中1,25(OH)2D 3、IL-10、IL-17含量,Th17及Treg水平。结果实验组患儿1,25(OH)2D 3、Treg及IL-10水平均低于对照组,Th17及IL-17水平高于对照组,差异有统计学意义(P<0.01)。干预组治疗后1,25(OH)2D 3、IL-10水平及Treg细胞比率较治疗前显著升高(P<0.05),IL-17水平及Th17细胞比率较治疗前显著降低(P均<0.05),且变化程度均较非干预组显著(P<0.05)。非干预组IL-10水平及Treg细胞比率有所下降,1,25(OH)2D 3、IL-17水平及Th17细胞比率有所增加,但治疗前后差异无统计学意义(P>0.05)。干预组患儿咳嗽及喘息消失时间均短于非干预组(P<0.05)。结论MPP患儿存在一定程度的维生素D缺乏及Th17/Treg表达失衡,补充维生素D可改善患儿Th17/Treg失衡及呼吸道症状。Objective To investigate the regulation of calcitriol on the expression of Th17/Treg and related factors in children with Mycoplasma pneumoniae pneumonia.Methods Fifty MPP children from September 2018 to December 2018 were selected as the experimental group and 50 healthy children as the control group.The levels of 1,25(OH)2D 3,IL-10 and IL-17 in plasma were detected by ELISA,and TH17 and Treg were detected by flow cytometry.The experimental group was randomly divided into VitD intervention group and non-VitD intervention group,25 cases in each group.In addition to routine treatment,children in VitD intervention group were given VitD orally.After two weeks,the levels of 1,25(OH)2D 3,IL-10,IL-17,Th17 and Treg in peripheral blood of the two groups were detected again.Results The levels of 1,25(OH)2D 3,Treg and IL-10 in the experimental group were lower than those in the control group,and the levels of Th17 and IL-17 in the experimental group were higher than those in the control group(P<0.01).The levels of 1,25(OH)2D 3,IL-10 and Treg cells in the intervention group were significantly higher than those before treatment(P<0.05),and the levels of IL-17 and Th17 cells were significantly lower than those before treatment(P<0.05),and the change course was significantly lower than that in the non-intervention group(P<0.05).The levels of IL-10 and Treg cell ratio decreased in non-intervention group,while the levels of 1,25(OH)2D 3,IL-17 and Th17 cell ratio increased,but there was no significant difference before and after treatment(P>0.05).The disappearance time of cough and wheeze in intervention group was shorter than that in non-intervention group(P<0.05).Conclusion Vitamin D deficiency and imbalance of Th17/Treg expression exist in MPP children.Vitamin D supplementation can improve the imbalance of Th17/Treg and respiratory symptoms in MPP children.

关 键 词：骨化三醇 肺炎支原体肺炎 TH17 TREG IL-10 IL-17 

分 类 号：R72[医药卫生—儿科]