黄精多糖对哮喘患儿红细胞免疫功能影响的体外实验研究

目的　观察黄精多糖 (PSP)对哮喘患儿红细胞免疫功能的影响及其意义。方法　采用花环试验法对哮喘患儿 (包括PSP组和生理盐水组 )及健康儿童进行红细胞C3b受体花环率及免疫复合物 (IC)花环率检测。结果　①哮喘组红细胞C3b受体花环率明显低于正常对照组 (t =6 .32 ,P <0 .0 1) ,IC花环率明显高于正常对照组 (t =5 .89,P <0 .0 1) ;②体外试验PSP组哮喘患儿红细胞C3b受体花环率较生理盐水组明显升高 (t =6 .33,P <0 .0 1) ,而IC花环率两组差异无显著性 (t =1.38,P >0 .0 5 ) ;③PSP在一定浓度范围内均可显著增加哮喘患儿红细胞C3b受体花环率且呈剂量依赖关系。结论　哮喘患儿红细胞免疫功能明显低下 ,PSP可增强哮喘患儿的红细胞免疫功能 ,这是其预防哮喘复发的机制之一     

贫血患儿红细胞免疫功能观察

为了解贫血患儿的红细胞免疫功能,对 ８５例贫血患儿（缺铁性贫血 ２９例、急性白血病 ２６例、地中海贫血 １８例、再生障碍性贫血 １２例）进行了红细胞 Ｃ３ｂ受体花环率（ＲＢＣ－Ｃ３ｂＲＲ）和红细胞免疫复合物花环率（ＲＢＣ－ＩＣＲ）测定。结果显示所有贫血患儿ＲＢＣ－Ｃ３ｂＲＲ均显著低于对照组儿童（Ｐ＜０．０１）,缺铁性贫血和再生障碍性贫血患儿 ＲＢＣ－ＩＣＲ与对照组比较无明显差异（Ｐ＞０．０５）,急性白血病患儿 ＲＢＣ－ＩＣＲ高于对照组（Ｐ＜０．０５）,地中海贫血患儿 ＲＢＣ－ＩＣＲ则显著高于对照组（Ｐ＜０．０１）。贫血患儿容易感染可能与红细胞免疫功能低下有关。     

血清胆红素对红细胞免疫功能的影响

目的 了解胆红素对红细胞免疫功能的影响。方法 对38例黄疸患儿进行胆红素和红细胞免疫功能检测,红细胞C3b补体受体花环(RBC-C3bRR)和红细胞免疫复合物受体花环(RBC-ICR)采用酵母多糖花环试验,血清胆红素采用苯甲酸尿素比色法。结果 发现该组患儿RBC-C3bRR,红细胞辅助因子(RIER)明显降低,而RBC-ICR,红细胞抑制因子(RIFR)明显升高,并发现RBC-C3bRR,RIER与胆红素浓度呈负相关,RBC-ICR,RIFR与胆红素浓度呈正相关。结论 血清胆红素能引起继发性红细胞免疫功能低下。     

支气管哮喘患儿红细胞免疫粘附肿瘤细胞能力的研究

目的：探讨支气管哮喘患儿自然条件下的红细胞免疫功能和免疫粘附肿瘤细胞的能力。方法：红细胞C3b受体花环率(RBC-C3bRR)、红细胞CIC受体花环率(RBC-ICRR)采用酵母菌花环试验。红细胞免疫粘附肿瘤细胞(RIT)采用C3b介导的免疫粘附实验。结果：支气管哮喘患儿RBC-C3bRR、RIT明显降低,RBC-ICRR明显升高。与对照组比较差异有显著性意义,均P<0.01。结论：支气管哮喘患儿红细胞免疫功能低下,红细胞膜受体活性在支气管哮喘患儿气道炎症中可能起到重要作用,可作为临床监测支气管哮喘病情的一个可靠指标。     

脑创伤患儿红细胞免疫功能的变化

目的探讨小儿脑创伤后红细胞免疫功能改变的意义。方法选取脑创伤患儿60例,按伤情分为轻型损伤和中重型损伤组。选取腹腔沟疝、隐睾各15例为对照组。酵母菌花环法检测其血红细胞C3b受体花环率(RBC-C3bRR)和红细胞免疫复合物花环率(RBC-ICR),放射免疫法测定其血清β-内啡肽(β-EP)水平,并对数据进行统计学分析。结果与对照组比较,脑创伤患儿组RBC-C3bRR明显下降(P<0.01),RBC-ICR和β-EP均明显升高(Pa<0.01);中重型创伤组各指标改变较轻型创伤组更明显(Pa<0.05)。脑创伤患儿β-EP变化与RBC-C3bRR呈直线负相关[r(轻型组)=-0.865;r(中重型)=-0.635Pa<0.05];β-EP变化与RBC-ICR呈直线正相关[r(轻型组)=0.644;r(中重型)=0.746Pa<0.05]。结论脑创伤患儿红细胞免疫功能明显下降,其改变与体内β-EP明显升高密切相关。     

当归多糖增强放射损伤小鼠胸腺细胞增殖及红细胞C3b受体粘附功能的实验研究

目的：进一步探讨当归多糖(Angelica polysaccharide, AP)的药用价值。方法：检测正常对照组、放射对照组及放射+当归多糖治疗组3组的刀豆蛋白A(ConA)诱导的胸腺细胞增殖反应和红细胞C3b受体花环率。结果：放射对照组胸腺细胞OD值和红细胞C3b受体花环率［(0.24±0.01),(16.46±0.76)%］明显低于正常对照组［(0.35±0.01),(22.30±1.26)%］,而放射+当归多糖治疗组的胸腺细胞OD值和红细胞C3b受体花环率［(0.31±0.01),(21.07±1.22%)］显著高于放射对照组［(0.24±0.01),(16.46±0.76)%］,P<0.01,有统计学意义。结论：当归多糖能明显增强放射损伤小鼠的胸腺细胞增殖和红细胞C3b受体免疫粘附功能。     

新生儿感染性疾病红细胞免疫功能及SOD的变化

对５种临床常见的新生儿感染性疾病（败血症、肺炎、脐炎、臀红、鹅口疮）的红细胞Ｃ３ｂ受体花环率（ＲＢＣ－Ｃ３ｂＲＲ）、免疫复合物花环率（ＲＢＣ－ＩＣＲ）、血清中红细胞免疫粘附促进因子（ＲＦＥＲ）及抑制因子（ＲＦＩＲ）以及红细胞超氧化物歧化酶（ＳＯＤ）的活性进行了检测，结果表明红细胞免疫功能及ＳＯＤ的变化与感染的严重程度及疾病的不同阶段密切相关。     

感染性腹泻患儿的红细胞免疫功能

本文对３６例感染性腹泻患儿进行红细胞Ｃ３ｂ受体花环率及红细胞免疫复合物花环率测定，结果红细胞Ｃ３ｂ受体花环率低于健康儿组，红细胞免疫复合物花环率高于健康组，表明感染性腹泻患儿红细胞免疫粘附活性下降，清除循环血中免疫复合物能力减弱，体内免疫复合物增加。而感染因子促使红细胞免疫功能降低，免疫功能低下，又导致反复感染，两者互为因果，造成恶性循环。     

支气管哮喘患儿免疫功能探讨

本文观察了116例支气管哮喘患儿的几项免疫指标,发现其白细胞吞噬防御功能降低,血小板数量明显低于对照组,免疫球蛋白含量发生显著改变,T、B淋巴细胞平衡失调。     

川崎病患儿红细胞补体受体1数量基因多态性及红细胞免疫的变化

目的了解川崎病患儿外周血红细胞补体受体1(ECR1)分子在川崎病急性期及恢复期的表达,初步探讨红细胞免疫功能与ECR1数量基因多态性的相关性。方法分别采用红细胞C3b受体花环率和红细胞免疫复合物花环率,并利用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)方法检测30例川崎病患儿(病例组)和28例健康儿童(对照组)的ECR1活性与ECR1数量基因多态性并进行比较。结果病例组患儿急性期红细胞C3b受体花环率低于对照组(P<0.01),恢复期病例组红细胞C3b受体花环率仍低于对照组(P<0.05),而红细胞免疫复合物花环率则接近对照组(P>0.05)。川崎病患儿HL和LL基因型的分布频率高于正常儿童(P<0.01),两组CR1等位基因的分布频率差异也有统计学意义,川崎病患儿L等位基因的分布频率明显高于正常儿童(P<0.01)。结论川崎病患儿急性期存在红细胞免疫功能低下,这是患儿CR1数量基因呈中低度表达所致,提示CR1基因的多态性可能在决定个体川崎病遗传易感性方面有重要作用。     

Effect of asthma intervention on children with undiagnosed asthma

OBJECTIVE: To measure the effect of an asthma intervention on the functional status and morbidity of children with undiagnosed asthma. STUDY DESIGN: Data from a randomized trial were used to compare outcomes at baseline and follow-up for children with undiagnosed and diagnosed asthma. We studied 510 symptomatic children with diagnosed asthma (diagnosed) and 299 children with symptoms but no diagnosis (undiagnosed). Baseline functioning and morbidity were similar for undiagnosed and diagnosed patients classified as moderate-severe. RESULTS: There were fewer undiagnosed reported allergies, seasonal symptoms, and other respiratory diagnoses (all P < 0.01). Among the moderate-severe, functional status, for example, symptom-days ( P = .02), symptom-nights ( P < .01), and days of restricted activity ( P < .01), was significantly reduced at follow-up for the undiagnosed in the intervention group but not for undiagnosed control subjects. Findings were similar for children with diagnosed asthma. CONCLUSIONS: Children with undiagnosed asthma were generally nonatopic, although some had symptoms at a level comparable to children with a diagnosis. The intervention successfully improved functional status for children with undiagnosed asthma as well as for children with diagnosed asthma. These results can be applied to ongoing discussions related to case detection.     

支气管哮喘患者TH细胞的极化状态及临床意义

目的：研究支气管哮喘患者TH细胞的极化状态与免疫调控。方法：对2003年1月至2004年3月住院患儿进行TH细胞检测,同时设正常儿童29人为对照组。对两组儿童应用ELISA法检测白细胞介素-2(IL-2)及γ干扰素(IFN-γ)水平,用单细胞内染色法检测TH1,TH2百分率。结果：支气管哮喘患者IL-2为15.94±3.07μg/L,与对照组的24.73±4.37μg/L比较,差异有显著性(P<0.01);IFN-γ为487.2±43.6pg/mL,水平也明显降低,与对照组的654.07±14.64pg/mL比较,差异有显著性(P<0.01);支气管哮喘患者TH1百分率(11.24±2.43)%亦明显低于对照组的(16.67±2.73)%,经t检验差异亦有显著性(P<0.01),支气管哮喘患者TH2百分率明显升高[(19.85±4.46)%vs(16.08±6.17)%;P<0.05]。结论：支气管哮喘患者机体TH1细胞数量及功能低下,TH1/TH2值下降,TH1/TH2极化异常,导致细胞毒性T细胞(CTL)介导的细胞免疫功能抑制。     

Effect of immunotherapy on autoimmune parameters in children with atopic asthma

There is an increased rate of reported autoantibody production in patients with atopic and nonatopic asthma. The possibility of generating autoantibodies after the induction of immunotherapy can be explained by several mechanisms. One of these is immune deviation from TH2 to TH1 response by the effect of immunotherapy in favor of unregulated response to self-antigens. The other theory is a possible antigenic mimicry enabling autoantibody formation in these patients, Sixty-three atopic asthmatic children were included in the study. The patients were divided into three groups: Group I: patients with atopic bronchial asthma without immunotherapy: Group II: patients receiving immunotherapy for a maximum of 3 years; Group III: patients receiving immunotherapy for 4-5 years. The autoantibodies examined in the study population were anti-nuclear antibody, anti-double stranded DNA, rheumatoid factor, liver-kidney microsomal antibody, anti-mitochondrial antibody, anti-thyroglobulin and anti-microsomal antibody, anti-Smith antibody and lupus anticoagulant. An overall incidence of 17.5% autoantibody positivity was observed in patients, with no statistical significance between the treatment groups. IgG levels were significantly elevated in Group III when compared with Group I. Based on these findings it is suggested, in accordance with other studies, that long-term immunotherapy in the pediatric age group does not cause a significant autoantibody formation other than the overall increased incidence that occurs in asthmatic patients.     

哮喘患儿长期吸入糖皮质激素对身高的影响

支气管哮喘(哮喘)是儿童最常见的慢性呼吸道疾病。吸入型糖皮质激素( inhaled corticoste-roid,ICS)是目前治疗哮喘最有效的药物,但近来亦有报道长期使用仍会产生一些不利影响。汇总近年来相关文献资料,ICS长期治疗可能会轻度地减缓身高的增长速度,但这种抑制只出现在哮喘治疗早期,并且不影响或仅轻度影响最终身高。 ICS对身高的影响,亦与其使用的种类、剂量和吸入方法相关。     

心理干预治疗对儿童哮喘的疗效观察

支气管哮喘是儿童期较常见的一种变态反应性疾病,严重威胁儿童健康,现在越来越引起世界各国的广泛关注.随着对哮喘发病机制认识的不断深入,治疗也在发生着变化.研究表明心理社会因素、心理家庭因素在哮喘的发生、发展和转归中起着重要作用[1,2];免疫学研究也发现哮喘变态反应的启动与心理因素有很大关系[3],因此,给予合适的心理干预以消除心理因素对哮喘患儿的不良影响就显得十分必要.目前世界卫生组织大力推广以吸入糖皮质激素为首选的哮喘治疗方案,我们对55例哮喘患儿在以糖皮质激素吸人为主的长期规范治疗的基础上辅以8周的心理干预综合治疗,取得了良好的效果,现报道如下.