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目的通过检测5岁以下喘息患儿外周血胸腺活化调节趋化因子(TARC)、总IgE及嗜酸性粒细胞(EOS)计数水平,探讨其在喘息评估中的临床意义。方法随机选取于本院就诊的5岁以下反复喘息患儿60例,分为有特应质高危因素的喘息Ⅰ组(n=36)和无特应质高危因素的喘息Ⅱ组(n=24)。同期随机选取本院同年龄组外科患疝气、肾结石等非感染性疾病术前患儿20例作为对照组(n=20)。采用ELISA法测定3组患儿血清TARC及总IgE水平,同时采用HE染色法进行外周血EOS计数。结果喘息Ⅰ组TARC水平及EOS计数均高于喘息Ⅱ组(Pa<0.05)和对照组(Pa<0.01),但喘息Ⅱ组与对照组比较,差异均无统计学意义(Pa>0.05);喘息Ⅰ组、喘息Ⅱ组血清IgE水平均高于对照组(Pa<0.05),但喘息Ⅰ组与喘息Ⅱ组比较,差异无统计学意义(P>0.05);喘息Ⅰ组血清TARC水平与外周血EOS计数呈正相关(r=0.771,P<0.01)。结论有特应质高危因素的5岁以下反复喘息患儿其发病机制与支气管哮喘相似,倾向于机体过敏因素引起,故对于5岁以下反复喘息患儿,如血清TARC水平与外周血EOS计数升高,且具有特应性体质,应按支气管哮喘进行干预治疗。无特应质危险因素的反复喘息患儿,其发病可能与呼吸道病毒感染有关。
Objective To investigate the clinical significance of peripheral blood thymus activation-regulating chemokine (TARC), total IgE and eosinophil count (EOS) in asthmatic children under 5 years of age. Methods Sixty children with recurrent wheeze under 5 years of age randomly selected from our hospital were divided into asthmatic group Ⅰ (n = 36) and wheezy group Ⅱ (n = 24) ). During the same period, 20 patients with non-infectious diseases such as hernia, kidney stones and other non-infectious diseases in the same age group were randomly selected as the control group (n = 20). Serum TARC levels and total IgE levels were measured by ELISA in all three groups. Peripheral EOS counts were also performed by HE staining. Results The level of TARC and the count of EOS in wheezing group Ⅰ were higher than those in wheezing Ⅱ group and Pazhou diapause group (P <0.01), but there was no significant difference between wheezing Ⅱ group and control group (Pa> 0.05). (P <0.05), but there was no significant difference between wheezing group Ⅰ and wheezing group Ⅱ (P> 0.05). The level of serum TEC in wheezing group Ⅰ was significantly higher than that of the control group (P <0.05) There was a positive correlation between blood EOS counts (r = 0.771, P <0.01). Conclusions Children with recurrent wheezing under 5 years of age who have special risk factors of high risk are similar to bronchial asthma and tend to be caused by allergic factors in the body. Therefore, for patients with recurrent wheezing under 5 years of age, such as serum TARC level and peripheral blood EOS count liters High, and with atopic constitution, should be bronchial asthma intervention. Children with recurrent wheezing without special risk factors may be related to respiratory virus infection.