特异性免疫治疗对支气管哮喘患儿Th1／Th2细胞因子表达及呼吸力学的影响

目的探讨特异性免疫治疗（SIT）对支气管哮喘患儿Th1／Th2细胞因子表达及呼吸力学的影响。方法87例支气管哮喘患儿按随机数字法分为2组，对照组（n=42例）采用对症支持疗法，观察组（n=45例）在对症支持治疗基础上加用SIT。比较两组治疗前后Th1／Th2细胞因子、IgE表达及呼吸力学的变化。结果治疗后观察组总有效率、血清IFN-γ表达水平及IFN-γ／／IL-4明显高于对照组（P〈0．05），而血清IL-4及IgE表达水平明显低于对照组（P〈0．05），差异均有统计学意义。结论对症支持的基础上加用SIT治疗小儿支气管哮喘能显著提高疗效，促进Th2细胞反应转移到Th1细胞反应，保持Th1／Th2平衡状态，进而改善呼吸力学参数。

The effect of specific immune therapy on expressions of Th1/Th2 cytokines and respiratory mechanics in children with bronchial asthma

Objective To investigate the effect of specific immune therapy（SIT） on the expression of Th1/Th2 cytokines and respiratory mechanics in children with bronchial asthma. Methods Eighty-seven children with bronchial asthma were randomly divided into control and observation groups. The control group （n = 42 cases ） was treated with symptomatic and supportive therapy, while the ob- servation group（ n = 45 cases） was treated with SIT on the basis of the control group. The expression of IgE, Th1/Th2 cytokines and re- spiratory mechanics of two groups were compared before and after treatment. Results The total effective rate of the observation group （93.3%） was significantly higher than that of the control group （78.6%） （P 〈 0. 05 ）. The expression levels of IFN-γ/ and ratio of IFN-γ/IL-4 in the observation group were significantly higher while the expression levels of serum IL-4 and IgE were significantly lower than that in the control group after treatment（ all P 〈 0. 05 ）. The respiratory mechanical parameters of the two groups after treatment were improved significantly （ P 〈 0. 05 ） but the observation group was improved more significantly （ P 〈 0. 05 ）. Conclusion The treat- ment of SIT for children with bronchial asthma has a remarkable curative effect. It could promote Th2 cell response transferring to Thl cell response, maintaining Th1/Th2 equilibrium state ,and then improve the respiratory mechanical parameters.