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目的探讨哮喘急性发作患儿外周血免疫细胞及相关因子的变化及意义。方法分别取107例哮喘患儿(哮喘组)治疗前(急性发作)和治疗后(哮喘缓解)外周静脉血,进行淋巴细胞表面IL-2受体(mIL-2R)、血浆可溶性IL-2受体(sIL-2R)、T淋巴细胞亚群检测。同时,选择20例年龄匹配的健康儿童作为对照组,10例有长期间歇性哮喘的患儿作为稳定哮喘组,均取外周静脉血,进行上述指标检测。结果治疗前,哮喘组CD3+、CD4+、CD8+细胞比率较对照组升高,差异有统计学意义(P均<0.05);CD4+细胞比率较稳定哮喘组高,差异有统计学意义(P<0.05)。治疗后,哮喘组CD3+、CD4+、CD8+细胞比率均较治疗前降低,差异有统计学意义(P均<0.01)。哮喘组治疗前mIL-2R表达量高于对照组,差异有统计学意义(P<0.05),哮喘组治疗后mIL-2R表达量低于治疗前,差异有统计学意义(P<0.01)。哮喘组治疗前血浆sIL-2R、IgE含量较对照组和稳定哮喘组显著升高,差异有统计学意义(P均<0.01)。哮喘组治疗后血浆IgE仍高于对照组(P<0.01)和稳定哮喘组(P<0.05);血浆sIL-2R降低到正常范围。结论哮喘急性发作患儿外周血CD3+、CD4+、CD8+淋巴细胞比率,淋巴细胞表面mIL-2R,血浆sIL-2R、IgE含量,均显著升高,这些指标均可作为哮喘急性发作的敏感标志物。
Objective To investigate the changes and significance of peripheral blood immune cells and related factors in children with acute asthma attack. Methods Peripheral venous blood was collected from 107 asthmatic children before asthma (acute attack) and after treatment (asthma relief), and the levels of IL-2 receptor (mIL-2R), soluble IL- Body (sIL-2R), T lymphocyte subsets detection. At the same time, 20 healthy children of age-matched control group were selected as control group. Ten children with long-term intermittent asthma as stable asthma group were given peripheral venous blood and the above indexes were detected. Results Before treatment, the ratio of CD3 +, CD4 + and CD8 + cells in asthma group was significantly higher than that in control group (P <0.05). The percentage of CD4 + cells in asthma group was significantly higher than that in stable asthma group (P <0.05) . After treatment, the ratio of CD3 +, CD4 + and CD8 + cells in asthma group was lower than that before treatment, the difference was statistically significant (all P <0.01). The expression of mIL-2R in asthma group was higher than that in the control group, the difference was statistically significant (P <0.05). The expression of mIL-2R in asthma group was lower than that before treatment, the difference was statistically significant (P <0.01). The levels of sIL-2R and IgE in asthma group before treatment were significantly higher than those in control group and stable asthma group (all P <0.01). Plasma IgE in the asthma group was still higher than that in the control group (P <0.01) and stable asthma group (P <0.05), and plasma sIL-2R was reduced to the normal range. Conclusion The levels of CD3 +, CD4 +, CD8 + lymphocytes, the levels of mIL-2R, sIL-2R and IgE in peripheral blood of children with acute asthma attack are both significantly increased. All of these indicators can be used as sensitive markers for acute asthma attacks.