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目的探讨喘息婴幼儿辅助性T细胞(Th)17/调节性T细胞(Treg)免疫平衡和肺功能变化及其相关性。方法选取2015年7月至2016年7月在河北省儿童医院呼吸科病房住院的感染性喘息患儿60例,非喘息患儿50例,以及健康体检儿童50例作为研究对象,测定Th17/Treg在喘息婴幼儿外周血中的变化及血清中白细胞介素-17(IL-17)、IL-10的表达情况,采用肺功能检测仪检测患儿潮气呼吸肺功能,回顾性分析其与肺功能的变化及其相关性。结果感染性喘息组患儿Th17/Treg、IL-17/IL-10水平明显高于非喘息组与健康对照组,差异均有统计学意义(P<0.05);感染性喘息组患儿到达潮气呼气峰流速时的时间/呼气时间、到达潮气呼气峰流速时的呼气量/呼气容积水平明显低于非喘息组与健康对照组,差异均有统计学意义(P<0.05)。经Pearson相关分析结果显示,感染性喘息患儿IL-17与到达潮气呼气峰流速时的时间/呼气时间、到达潮气呼气峰流速时的呼气量/呼气容积潮气呼吸肺功能指标呈负相关(r=-0.327 5、-0.452 5),差异均有统计学意义(P<0.05);感染性喘息患儿IL-10与潮气呼吸肺功能指标呈正相关(r=0.292 1、0.490 3),差异有统计学意义(P<0.05)。对感染性喘息组患儿进行6个月随访了解预后,60例感染性喘息组患儿中有24例(40.00%)发展为哮喘,36例(60.00%)未发展为哮喘,哮喘组患儿Th17/Treg和肺功能变化与未发展为哮喘组患儿有明显差异,差异有统计学意义(P<0.05)。结论 Th17/Treg免疫平衡与喘息婴幼儿肺功能变化存在一定的相关性。早期监测喘息婴幼儿外周血Th17/Treg及相关细胞因子(IL-17/IL-10)和肺功能可作为预测儿童哮喘发生的可靠性指标,对婴幼儿哮喘具有一定的预测意义,对患儿进行早期干预、治疗,可有效减轻社会及家庭经济负担。
Objective To investigate the changes of immune balance and pulmonary function of Helper T helper 17 (Th) 17 / Tregs and their correlations. Methods From July 2015 to July 2016, 60 children with infectious wheezing, 50 non-wheezing children and 50 healthy children were enrolled in the Respiratory Unit of Children’s Hospital of Hebei Province. The Th17 / Treg The changes of peripheral blood of wheezing infants and young children and the expression of IL-17 and IL-10 in the serum were detected. The lung function of the children was detected by the pulmonary function detector. The pulmonary function was analyzed retrospectively Changes and their relevance. Results The levels of Th17 / Treg and IL-17 / IL-10 in children with infectious wheezing were significantly higher than those in non-wheezing and healthy controls (P <0.05) The expiratory volume / expiratory volume at expiratory peak flow reached a significantly lower level than that in the non-asthmatic group and the healthy control group (P <0.05) . Pearson correlation analysis showed that IL-17 in asthmatic children with asthmatic infantile respiratory failure time and expiratory time, expiratory volume / expiratory volume at expiratory peak expiratory flow rate (R = -0.327 5, -0.452 5), the differences were statistically significant (P <0.05). IL-10 in respiratory asthmatic children was positively correlated with pulmonary function index (r = 0.292, 3), the difference was statistically significant (P <0.05). The prognosis of children with infectious wheeze was followed up for 6 months. 24 (40.00%) of 60 children with infectious wheezing developed asthma and 36 (60.00%) did not develop asthma. Children with asthma There was a significant difference between Th17 / Treg and lung function changes in children without asthma (P <0.05). Conclusion There is a certain correlation between Th17 / Treg immune balance and asthmatic pulmonary function in infants and young children. Early monitoring of peripheral blood Th17 / Treg and related cytokines (IL-17 / IL-10) and lung function in asthmatic infants can be used as a reliable indicator to predict the occurrence of asthma in infants and young children with asthma has a certain prognostic significance of children Early intervention, treatment, can effectively reduce the social and family financial burden.