不同时期哮喘儿童血清维生素D水平及T淋巴细胞免疫变化的研究  

Study on the changes of serum vitamin D level and T lymphocyte immunity in children with asthma at different stages

作　　者：李敏[1] 杨国建 蓬青梅 LI Min;YANG Guo-jian;PENG Qin-mei(Department of Pediatrics,Sichuan Academy of Medical Science&Sichuan Provincial People's Hospital,Chengdu,Sichuan 610072,China)

机构地区：[1]四川省医学科学院·四川省人民医院儿科,四川成都610072

出　　处：《中国儿童保健杂志》2021年第3期335-338,共4页Chinese Journal of Child Health Care

摘　　要：目的分析不同时期哮喘患儿血清25羟维生素D3[25-(OH)D3]水平、T淋巴细胞数目及相关细胞因子的变化及相关性,探讨25-(OH)D3参与哮喘发病和进展的可能发病机制。方法选取2018年1月-2019年12月就诊于四川省人民医院的105例哮喘儿童(包括急性发作期25例、慢性持续期和缓解期各40例)和30例健康儿童,用电化学法之溶出伏安法检测25-(OH)D3水平、流式细胞学方法检测T淋巴细胞亚群及其细胞因子γ-干扰素(IFN-γ)、白介素-4(IL-4)、白介素-10(IL-10)水平。结果哮喘患儿血清25-(OH)D3水平明显降低、CD3、CD4/CD8细胞数量减少,IFN-γ、IL-10分泌水平降低及IL-4分泌水平增高;其中急性发作期变化最明显、慢性持续期次之、缓解期最接近正常水平;不同时期哮喘患儿血清25-(OH)D3水平与IFN-γ、IL-10水平呈正相关,与IL-4水平呈负相关。结论维生素D作为一种免疫调节激素与支气管哮喘的发生、疾病控制密切相关,监测哮喘患者血清25-(OH)D3水平有助于病情的判断及疾病的治疗,为哮喘临床提供了新的监测手段。Objective To analyze the changes and correlation of serum 25-hydroxyvitamin D3[25-(OH)D3],the number of T lymphocytes and related cytokines in children with asthma at different stages,and to explore the possible mechanism of 25-(OH)D3 involved in the pathogenesis and progression of asthma.Methods From January 2018 to December 2019,a total of 105 children with asthma and 30 healthy children in Sichuan Provincial People′s Hospital were selected into this study,including 25 cases of acute attack,40 cases of chronic duration and 40 cases of remission.The level of 25-(OH)D3 were detected by electrochemical stripping voltammetry and the levels of T lymphocyte subsets and their cytokines IFN-γ,IL-4 and IL-10 were detected by flow cytometry.Results In children with asthma,serum 25-(OH)D3level decreased significantly,the number of CD3,CD4/CD8 cells as well as the secretion level of IFN-γand IL-10 decreased,while the level of IL-4 secretion increased.Changes were most pronounced during acute episodes,followed by chronic persistence,and closest to normal during remission.The level of serum 25-(OH)D3 in children with asthma at different stages was positively correlated with the level of IFN-γand IL-10,and negatively correlated with the level of IL-4.Conclusions Vitamin D,as an immunomodulatory hormone,is closely related to the onset and disease control of asthma.Monitoring serum 25-(OH)D3 levelof asthmatic patients is helpful for the judgment and the treatment of the disease condition,providing a new monitoring method for the clinical practice.

关 键 词：儿童哮喘 维生素D T细胞亚群 细胞因子 

分 类 号：R725.6[医药卫生—儿科]