特异性免疫治疗对支气管哮喘患儿Treg水平及肺功能的影响  

The effect of specific immunotherapy on the level of Treg and pulmonary function in children with bronchial asthma

作　　者：张义 杨勤[1] 靳蓉[2] 王菲[2] 刘燕[2] ZHANG Yi;YANG Qin;JIN Rong;WANG Fei;LIU Yan(Department of Pathology andPathophysiology,Guizhou Medical University,Guiyang 550002,China;Department of ChildRespiratory.Guiyang Maternal and Child Health Hospital,Guiyang 550003,China)

机构地区：[1]贵州医科大学病理学及病理生理学教研室,贵阳550002 [2]贵阳市妇幼保健院儿童呼吸科,贵阳550003

出　　处：《现代免疫学》2021年第3期224-230,共7页Current Immunology

摘　　要：为探讨特异性免疫治疗对支气管哮喘患儿Treg水平及肺功能的影响,选取60例支气管哮喘患儿,随机分为试验组和对照组(30例/组)。对照组给予基础用药治疗,试验组在基础用药治疗的同时给予特异性免疫治疗,比较2组治疗前后Treg水平和肺功能的变化。结果显示,治疗1年后2组CD4+CD25highT细胞、CD4+CD25highCDl27lowTreg、IL-10及IgG 4水平均升高(均P<0.05),且试验组高于对照组(P<0.05);治疗1年后2组TGF-β1、特异性IgE (specific IgE,sIgE)水平均下降(均P<0.05),且试验组低于对照组(均P<0.05);第1秒用力呼气量(forced expiratory volume in the first second,FEV1)、最大呼气流量(peak expiratory flow,PEF)、用力呼出50%肺活量的呼气流量(50%of forced expiratory flow,FEF50)、用力呼出75%肺活量的呼气流量(75%of forced expiratory flow,FEF75)、最大呼气中期流量(maximal mid-expiratory flow,MMEF)、呼出气一氧化氮(fractional exhaled nitric oxide,FeN O)、肺泡呼出气一氧化氮(concentration alveolar nitric oxide,CaN O)的时间、组间、交互作用比较,差异均有统计学意义(均P<0.05);2组上述肺功能指标均随时间的延长逐渐升高,呼出气参数均随时间的延长逐渐下降,除试验组治疗9个月后与治疗1年后均基本相近外(P>0.05),组内其余每2个时刻间比较,差异均有统计学意义(均P<0.05);治疗前2组间肺功能指标和呼出气参数比较,差异均无统计学意义(P>0.05),治疗3个月后、6个月后、9个月后、1年后试验组肺功能指标均高于对照组(P<0.05),呼出气参数均低于对照组(P<0.05)。该研究提示,对支气管哮喘患儿给予特异性免疫治疗可改善Treg水平,还可改善炎性因子、免疫指标水平,且对肺功能、呼出气参数也有明显的改善作用。To explore the effect of specific immunotherapy on the level of Treg and pulmonary function in children with bronchial asthma,60 children with bronchial asthma were enrolled,and randomly divided into the experimental group and the control group with 30 cases each. The control group was given the basic medication,and the experimental group was given the specific immunotherapy in addition to the basic medication. The changes of Treg level and pulmonary function before and after treatment in the two groups were compared. One year later,the levels of CD4+CD25highT cells,CD4+CD25highCDl27lowTreg,IL-10 and IgG 4 in both groups increased( P<0.05),with the higher levels in the experimental group than those in the control group( P<0.05). One year later,the levels of TGF-β1 and specific IgE( sI gE) in both groups decreased( P<0.05),with the lower levels in the experimental group than those in the control group( P<0.05). There were significant differences in forced expiratory volume in the first second( FEV1),peak expiratory flow( PEF),50% of forced expiratory flow( FEF50),75% of forced expiratory flow( FEF75),maximal mid-expiratory flow( MMEF),fractional exhaled nitric oxide( FeN O),concentration alveolar nitric oxide( CaN O) in time,interaction and groups( P< 0.05). The pulmonary function indexes of the two groups increased with time,and the respiratory parameters decreased with time. Except for the experimental group after 9 months and 1 year( P>0.05),there were significant differences between the other two time points in the two groups( P<0.05). There was no significant difference in pulmonary function and respiratory parameters between the two groups before treatment( P>0.05). After 3 months,6 months,9 months and 1 year,the pulmonary function indexes of the experimental group were higher than those of the control group( P<0.05),and the respiratory parameters were lower than those of the control group( P<0.05).Therefore,specific immunotherapy for children with bronchial asthma can improve the level of Treg,inflammatory

关 键 词：特异性免疫治疗 支气管哮喘 调节性T细胞 肺功能 

分 类 号：R562.5[医药卫生—呼吸系统]