腺样体肥大患儿血清炎症介质和淋巴细胞亚群表达特征及与患儿预后的相关性

目的研究腺样体肥大患儿血清炎症介质、淋巴细胞亚群表达特征及其与患儿预后的相关性。方法选取浙江中医药大学附属第三医院收治的86例腺样体肥大患儿(观察组)和86例健康儿童(对照组)作为研究对象,采集血液标本测定血清炎症介质及淋巴细胞亚群相关指标,对比两组儿童的测定结果。分析腺样体肥大患儿的肥大程度、腺样体再增生情况,对比不同肥大程度患儿的血清指标,并分析各指标与患儿病情程度及预后(腺样体再增生)的关系。结果观察组患儿肿瘤坏死因子-α(TNF-α)、可溶性白细胞介素-2受体(sIL-2R)及白细胞介素-6(IL-6)水平分别为(492.44±50.56)mg/L、(420.48±61.79)U/ml及(33.65±4.51)pg/ml,对照组儿童分别为(301.22±41.65)mg/L、(236.55±57.90)U/ml及(16.25±3.27)pg/ml,差异均有统计学意义(t=16.004,P<0.05;t=20.311,P<0.05;t=8.995,P<0.05)。观察组CD4⁺、CD8⁺及CD4⁺/CD8⁺水平分别为(35.75±7.05)、(16.22±2.69)及(1.46±0.67),对照组分别为(34.25±4.53)、(17.62±2.35)及(1.40±0.62),差异均无统计学意义(t=1.036,P>0.05;t=0.905,P>0.05;t=0.823,P>0.05)。相比腺样体中度肥大患儿,重度肥大患儿的TNF-α、sIL-2R、IL-6、CD4⁺及CD4⁺/CD8⁺水平明显更高(P<0.05)。相比未增生患儿,腺样体再增生患儿的TNF-α、sIL-2R、IL-6、CD4⁺及CD4⁺/CD8⁺水平明显更高(P<0.05)。相关分析显示,患儿腺样体肥大程度与TNF-α、sIL-2R、IL-6、CD4⁺及CD4⁺/CD8⁺水平均呈正相关(P<0.05)。患儿腺体再增生与TNF-α、sIL-2R、IL-6、CD4⁺及CD4⁺/CD8⁺水平也呈正相关(P<0.05)。结论腺样体肥大患儿的血清炎症介质及部分T淋巴细胞亚群表达显著升高,其与腺样体肥大程度、患儿预后密切相关。

Expression characteristics of serum inflammatory mediators and lymphocyte subsets in children with adenoid hypertrophy and the relationship with prognosis

Objective To study the expression characteristics of serum inflammatory mediators and lymphocyte subsets in children with adenoid hypertrophy and the correlation with prognosis.Methods 86 children with adenoid hypertrophy(observation group)and 86 healthy children(control group)treated in the Third Affiliated Hospital of Zhejiang University of traditional Chinese medicine were selected as the research objects.Their blood samples were collected to determine the related indexes of serum inflammatory mediators and lymphocyte subsets,and the results of the two groups were compared.The degree of hypertrophy and adenoid re hyperplasia in children with adenoid hypertrophy were analyzed,and the serum indexes of children with different degrees of hypertrophy were compared,and the relationship between each index and the degree of illness and prognosis(adenoid re hyperplasia)were analyzed.Results The levels of tumor necrosis factor-α(TNF-α),soluble interleukin-receptor(sIL-2 R)and interleukin-6(IL-6)in observation group were(492.44±50.56)mg/L,(420.48±61.79)U/ml,(33.65±4.51)pg/ml,the control group were(301.22±41.65)mg/L,(236.55±57.90)U/ml,(16.25±3.27)pg/ml,There were significant differences in TNF-α,sIL-2 R and IL-6 between the observation group and the control group(t=16.004,P<0.05;t=20.311,P<0.05;t=8.995,P<0.05).The levels of CD4;,CD8;and CD4;/CD8;were(35.75±7.05),(16.22±2.69),(1.46±0.67)in the observation group,and(34.25±4.53),(17.62±2.35),(1.40±0.62)in the control group,There was no significant difference in CD4;,CD8;,CD4;/CD8;between the two groups(t=1.036,P>0.05;t=0.905,P>0.05;t=0.823,P>0.05).Compared with non proliferative children,the levels of TNF-α,SIL-2 R,IL-6,CD4;,CD4;/CD8;in children with adenoid hyperplasia were significantly higher(P<0.05).Correlation analysis showed that the degree of adenoid hypertrophy in children was positively correlated with the levels of TNF-α,SIL-2 R,IL-6,CD4;,CD4;/CD8;(P<0.05).Adenoid hyperplasia in children was also positively correlated with the levels of TNF-α,SIL-2 R,IL-6,CD4;,CD4;/CD8;(P<0.05).Conclusion The expression of serum inflammatory mediators and some T lymphocyte subsets in children with adenoid hypertrophy is significantly increased,which is closely related to the degree of adenoid hypertrophy and the prognosis of children.