呼吸道合胞病毒感染时气道重塑相关因子失调与内源性血浆皮质醇的相关性

目的 通过测定急性呼吸道合胞病毒( RSV)感染时内源性血浆皮质醇浓度和气道重塑相关因子,揭示RSV感染时内源性血浆皮质醇和气道重塑相关因子之间的关系.方法 选择42例急性RSV感染患儿,其中重症21例(重症组),轻症21例(轻症组),另选择21例同期健康婴儿作为对照组.ELISA方法检测血清基质金属蛋白酶-9(MMP-9)、金属蛋白酶组织抑制物-1(TIMP-1)及转化生长因子-β1(TGF-β1)水平,放射免疫分析法检测血浆皮质醇水平.结果 重症组血浆皮质醇水平为(236.25±119.87)μg/L,与轻症组的(130.62±73.04)μg/L和对照组的(56.35±34.52)μg/L比较差异有统计学意义(P＜0.05),轻症组与对照组比较差异有统计学意义(P＜0.05).重症组血清TIMP-1和TGF-β1水平高于轻症组(P＜0.05),轻症组高于对照组(P＜0.05)；重症组MMP-9/TIMP-1低于对照组(P＜0.05)；重症组血清MMP-9水平高于轻症组(P＜0.05).重症组淋巴细胞、嗜酸粒细胞、CD4+、CD8+均较轻症组和对照组降低(P＜0.05)；轻症组嗜酸粒细胞、CD8+均较对照组降低(P＜0.05).结论 RSV感染可导致患儿气道重塑相关因子失衡,存在气道重塑的高危因素,可能与血浆皮质醇水平增高有关,从而导致难治性喘息性疾病的存在.

Relationship between the disturbance of airway remodeling associated cytokines and endogenous plasma cortisol in respiratory syncytial virus infection

Objective To explore the relationship between the endogenous plasma cortisol and the airway remodeling associated cytokines which was infected respiratory syncytial virus (RSV) through measuring the levels of them.Methods Forty-two infants diagnosed as acute RSV infection were divided into two groups,severe group(21 cases) and mild group(21 cases),as well as 21 healthy infants for control group.The levels of matrix metalloproteinase-9 (MMP-9),tissue inhibitor of metalloproteinase-1 (TIMP-1) and transforming growth factor- β1 (TGF- β 1) were determined by ELISA,the levels of plasma cortisol were determined by radio immunoaasay.Results The levels of plasma cortisol in severe group (236.25 ± 119.87)μg/L] were significantly higher than those in mild group (130.62 ±73.04)μg/L] and control group (56.35 ±34.52)μg/L],there were significant differences (P ＜0.05),and the mild group was significandy higher than the control group(P＜ 0.05).The levels of TIMP-1 and TGF- β 1 in severe group were significantly higher than those in mild group(P＜ 0.05),and the mild group was significantly higher than the control group (P ＜ 0.05 ); the ratio of MMP-9 and TIMP-1 in severe group was significantly lower than that in control group (P ＜0.05);the levels of MMP-9 in severe group were significantly higher than those in mild group (P ＜0.05).The levels of lymphocytes,eosinophilic cells and CD4+,CD8+ in severe group were significantly lower than those in mild group (P＜0.05),and significantly lowerthan those in control group (P ＜ 0.05 ).The levels of eosinophilic cells and CD8+ in mild group were significantly lower than those in control group(P ＜ 0.05 ).Conclusion The infection of RSV results in the imbalance of the airway remodeling associated cytokines,which is a danger factor,and the imbalance may be related to the increased level of the plasma cortisol.