哮喘患儿血清T细胞亚群、细胞因子和免疫球蛋白的动态变化及意义

目的探讨哮喘患儿血清T细胞亚群、细胞因子和免疫球蛋白的动态变化及临床意义，为哮喘的发病机制及抗变态反应治疗提供理论依据。方法对40例哮喘患儿（哮喘发作组和哮喘缓解组）及25例健康体检儿童（对照组）应用流式细胞仪测定CD3＋、CD4＋、CD8＋T细胞，应用ELISA法测定TNF—α、白细胞介素（IL）-6、IL-8和IgE，应用免疫比浊法测定IgG、IgA和IgM。结果哮喘发作组CD3＋、CD4＋T细胞及CD4＋／CD8＋显著高于对照组（P〈0．01），CD4＋T细胞及CD4＋／CD8＋明显高于哮喘缓解组（P〈0．05）；哮喘缓解组CD4＋T细胞及CD4＋／CD8＋明显高于对照组（P〈0．05）。哮喘发作组IL-6、IL-8及TNF—α均明显高于哮喘缓解组和对照组（P〈0．05或〈0．01），哮喘缓解组TNF—α与对照组比较差异有统计学意义（P〈0．05）。哮喘发作组IgE及IgG水平显著高于哮喘缓解组和对照组（P〈0．01或〈0．05），IgA水平显著低于对照组（P〈0．01）；哮喘缓解组IgE水平仍显著高于对照组（P〈0.01）。结论哮喘患儿发作期和缓解期均存在免疫失衡，提示哮喘患儿应长期抗变态反应治疗。

The changes and significance of T-cell subgroups,cytokines and immunoglobulins in children with asthma

Objective To study the changes of serum levels of T-cell subgroups, cytokines and immunoglobulins on the pathogenesis of asthma in children, and explore the role of them in the pathogenesis of asthma. Methods Forty children with asthma （asthma attack group and asthma convalescence group） and 25 healthy children （control group）were enrolled in this study. The level of CD3＋, CD4＋ and CD8＋ T-cell were determined using flow cytometry （FCM）. The levels of TNF- α, IL-6, IL-8 and IgE were determined using ELISA, the level of IgG, IgA and IgM were detected by immunoturbidimetry. Results Compared with control group, there were higher levels of CD3＋ and CD4＋ T-cell and CD4＋/CD8＋ in asthma attack group （P 〈 0.01 ）, and higher levels of CD4＋ T-cell and CD4＋/CD8＋ in asthma convalescence group （P 〈 0.05）, while no difference in the level of CD8＋ T- cell. The level of CD4＋ T-cell and CD4＋/CD8＋ were higher in asthma convalescence group than those in control group （P 〈 0.05）. The levels of IL-6, IL-8 and TNF-α in asthma attack group were higher than those in asthma convalescence group and control group （P 〈 0.05 or 〈 0.01 ）, the level of TNF- α was significantly higher in asthma convalescence than that in control group （P 〈 0.05 ）.There were higher levels of IgE and IgG in asthma attack group than those in asthma convalescence group and control group（P 〈 0.01 or 〈 0.05）, the level of IgA was lower than that in control group （P 〈 0.01 ）. There was higher level of IgE in asthma convalescence group than that in control group （P 〈 0.01 ）. Conclusions The immune imbalance exists in children with asthma at both attack and convalescence stages. A long-time anti-allergy treatment for childhood asthma is necessary.