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目的了解毛细支气管炎与支气管哮喘患儿辅助性T淋巴细胞亚群表达的异同。方法毛细支气管炎组34例。男20例,女14例;年龄1～15(6.65±4.22)个月。经鼻咽部分泌物间接免疫荧光和(或)病毒血清IgM抗体检测证实,均为病毒感染所致,其中呼吸道合胞病毒23例,副流感、流感各4例,腺病毒3例。患儿双肺均可闻及不同程度的喘鸣音及中细湿啰音,均有不同程度发热(其中<38℃20例、38～39℃12例、>39℃2例);入院时末梢血白细胞多数正常。同期住院的支气管哮喘发作期患儿(支气管哮喘组)21例。男12例,女9例;年龄3～13(8.05±2.85)岁。对二组患儿均采用流式细胞仪收获细胞,并对其外周血T淋巴细胞亚群进行检测,检测CD4+细胞群中只分泌IFN-γ或IL-4细胞的百分数,分别代表辅助性T淋巴细胞Th1及Th2的百分数。结果毛细支气管炎组CD4+细胞百分率及CD4/CD8比值较支气管哮喘组高,差异有统计学意义(Pa=0.002);毛细支气管炎组与支气管哮喘组比较Th1细胞百分率无统计学差异,但Th2细胞百分率却较支气管哮喘组明显降低,差异有统计学意义(P=0),而Th1/Th2比值显著高于支气管哮喘组有统计学差异(P=0.031)。结论与支气管哮喘相比,毛细支气管炎患者呈现相对的Th1优势反应,二者的治疗策略也必然有所不同。
Objective To understand the similarities and differences of the expression of helper T lymphocyte subsets in children with bronchiolitis and bronchial asthma. Methods Bronchiolitis group of 34 cases. There were 20 males and 14 females, ranging in age from 1 to 15 (6.65 ± 4.22) months. Nasopharyngeal secretions by indirect immunofluorescence and (or) virus serum IgM antibody test results were confirmed by the virus infection, including respiratory syncytial virus in 23 cases, parainfluenza, influenza in 4 cases, 3 cases of adenovirus. Children with both lungs can smell different degrees of wheezing and fine wet rales, have different degrees of fever (including <38 ℃ in 20 cases, 38 ~ 39 ℃ in 12 cases,> 39 ℃ in 2 cases); admission Most peripheral blood leukocytes normal. The same period hospitalized patients with bronchial asthma (bronchial asthma group) in 21 cases. There were 12 males and 9 females, ranging in age from 3 to 13 (8.05 ± 2.85) years. In both groups, the cells were harvested by flow cytometry, and the T lymphocyte subsets in peripheral blood were detected. The percentages of secreting IFN-γ or IL-4 only in CD4 + cell population were detected, representing T Lymphocyte Th1 and Th2 percentage. Results The percentage of CD4 + cells and the ratio of CD4 / CD8 in bronchiolitis group were significantly higher than those in bronchial asthma group (Pa = 0.002). There was no significant difference in the percentage of Th1 cells between bronchiolitis group and bronchial asthma group, but Th2 cells The percentage was significantly lower than that of bronchial asthma group, the difference was statistically significant (P = 0), while the Th1 / Th2 ratio was significantly higher than the bronchial asthma group was statistically significant (P = 0.031). Conclusion Compared with bronchial asthma, patients with bronchiolitis showed a relative Th1 predominant response, and the treatment strategies of the two were necessarily different.