糖皮质激素吸入对哮喘儿童血清IL-4和IL-12水平的影响

目的　观察哮喘儿童血清白细胞介素 (IL) -4、IL -12水平和肺功能的变化及糖皮质激素对其的影响。方法　采用ELISA法分别检测轻、中度哮喘急性发作期儿童 (2 5例 )吸入丙酸倍氯米松 1周前后 ,缓解期儿童 (2 0例 )和健康对照组 (15例 )血清中IL -4和IL -12水平 ,并同时测 1s用力呼气容积 (FEV1)占预计值的百分比。结果　急性发作期患儿治疗前IL -12值明显下降 ,与缓解期、健康对照组比较差异有显著性 (P均 <0 .0 1) ;急性发作期患儿治疗前IL -4值明显升高 ,与健康对照组比较差异有显著性 (P <0 .0 1) ;急性发作期及缓解期FEV1占预计值的百分比较健康对照组下降 (P均 <0 .0 1) ;急性发作期患儿治疗后IL -12水平明显升高 ,IL -4水平下降 ,FEV1占预计值的百分比升高 (P <0 .0 1)。急性发作期治疗前患儿血清IL -12与IL -4呈负相关 (r =-0 .5 3 2 ,P <0 .0 1)。结论　哮喘儿童血清中IL -4水平升高 ,IL -12水平下降 ,糖皮质激素可使IL -4水平下降 ,IL -12水平升高 ,改善哮喘患儿肺功能。

Effects of Inhaled Glucocorticoid Treatment on the Levels of IL-4 and IL-12 in Asthma Children

Objective To observe the effects of inhaled glucocorticoid treatment on the levels of interleukin (IL-4, IL-12) and the changes in pulmonary function. Methods ELISA method was used to observe the serum IL-4 and IL-12 levels of the 20 children in the paracmasia and the control 15 children of the light and moderate acute asthma in 25 children who inhaled beclometasone dipropionate before and after the period of onset. Meanwhile the percentage of predicted value of FEV 1 in 1s was also detected. Results It exhibited a dramatic decline in the IL-12 value of the asthma children in the period of onset prior to treatment and there existed a significance (P<0.01) compared with those in the in the paracmasia and the control group. The IL-4 level obviously rose in children in the period of onset prior to treatment with a significance of up to P<0.01 compared with the control group. The percentage of predicted values of FEV 1 in the periods of onset and paracmasia decreased compared with the control group (P<0.01). The IL-12 levels in the asthma children receiving treatment in the period of onset obviously increased with a fall of the IL-4 level and the percentage of predicted value of the FEV 1 increased (P<0.01). A negative correlation existed in the serums levels of IL-12 and IL-4 of asthma children in the period of onset before treatment (r=-0.532,P<0.01). Conclusion The serums level of IL-4 in asthma children proves to be high while that of the IL-12 is low. Glucocorticoid can lead to the decrease of IL-4 level and increase of the IL-12 level so as to improve the pulmonary functions of the asthma children.