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目的探讨患过敏性疾病的婴幼儿在出生时脐血IL-10、IL-4、IgE的变化及三者之间的关系。方法随机采集329份新生儿脐血标本,应用ELISA方法测定IL-10、IL-4、IgE水平。对329名新生儿进行随访,前瞻性地追踪观察各种过敏性疾病的发生情况。采用SPSS统计软件的单因素分析和多因素Logistic回归分析确定各种因素对过敏性疾病发生的影响。结果患过敏性疾病组脐血IL-4、IgE水平较未患过敏性疾病组明显增高(P均<0.01)。而IL-10水平较后者明显降低(P<0.01);患过敏性疾病患儿脐血的三种介质的相关分析显示:两两之间呈显著相关,即IL-4与IgE之间呈显著正相关(r=0.734,P<0.001);IL-10与IL-4呈显著负相关(r=-0.593,P<0.001);IL-10与IgE亦呈显著负相关(r=-0.694,P<0.001);Logistic回归分析结果表明阳性家族哮喘史、阳性家族过敏史、脐血中IL-4和IL-10四个因素与过敏性疾病的发生关系密切,其中阳性家族哮喘史的相对危险度最高。结论阳性家族过敏史、阳性家族哮喘史、脐血IL-4增高或IL-10降低是婴幼儿期过敏性疾病发生的重要危险因素。通过观察出生时新生儿脐血IL-4、IL-10、IgE水平的变化可预测婴幼儿过敏性疾病的发生。
Objective To investigate the changes of IL-10, IL-4, IgE in cord blood of infants and young children with allergic diseases at birth and the relationship between the three. Methods 329 neonatal umbilical cord blood samples were collected randomly and the levels of IL-10, IL-4 and IgE were measured by ELISA. 329 newborns were followed up prospectively to observe the occurrence of various allergic diseases. Univariate analysis and multivariate logistic regression analysis using SPSS statistical software to determine the impact of various factors on the occurrence of allergic diseases. Results The levels of IL-4 and IgE in cord blood of patients with allergic diseases were significantly higher than those without allergic diseases (all P <0.01). While the level of IL-10 was significantly lower than that of the latter (P <0.01). Correlation analysis of the three media of umbilical blood in children with allergic diseases showed that there was a significant correlation between each pair of IL-10, that is, between IL-4 and IgE (R = -0.593, P <0.001). There was also a significant negative correlation between IL-10 and IgE (r = -0.694 , P <0.001). Logistic regression analysis showed that the positive family history of asthma, the history of positive family allergy, the four factors of IL-4 and IL-10 in cord blood were closely related to the occurrence of allergic diseases, The highest risk. Conclusions Positive family history of allergy, positive family history of asthma, elevated cord blood IL-4 or IL-10 is an important risk factor for the development of allergic diseases in infancy. By observing the changes of neonatal cord blood IL-4, IL-10, IgE levels at birth can predict the occurrence of allergic diseases in infants and young children.