大剂量丙种球蛋白对喘息婴儿外周血IL-4和CD20水平以及喘息再发的影响

目的:观察大剂量丙种球蛋白对喘息婴儿外周血IL-4和CD20水平以及喘息再发的影响。方法:用流式细胞术和ELISA法分别检测30例正常婴儿和66例喘息婴儿外周血CD20+细胞数和IL-4水平,随访记录婴儿的喘息缓解时间和半年内再喘息率。结果:喘息婴儿外周血的IL-4与CD20+细胞水平明显高于正常对照组(P0.01)。常规治疗前后患儿外周血的IL-4水平分别为(155.13±29.82)ng/L与(92.21±14.55)ng/L,P0.01,但治疗后的水平仍明显高于正常对照组(P0.05);CD20水平分别为(35.60±7.27)%与(22.73±6.19)%,P0.01,治疗后的水平仍明显高于正常对照组(P0.05)。丙种球蛋白治疗前后IL-4水平分别为(142.87±36.51)ng/L与(57.31±12.68)ng/L,P0.01;CD20水平分别为(37.12±8.51)%与(18.46±5.34)%,P0.01,治疗后IL-4与CD20水平与正常对照组无显著差异。丙种球蛋白组患儿的喘息消失时间(4.18±1.75)d明显短于常规治疗组(5.92±1.33)d,P0.01。丙种球蛋白组半年内出现再喘息率(12.12%)明显低于常规治疗组(33.33%),P0.05。结论:喘息发作婴儿外周血中IL-4与CD20+细胞水平明显增高,大剂量丙种球蛋白可较迅速缓解婴儿喘息症状和减少喘息再发率的机制可能与IL-4水平和CD20+细胞数下降有关。

Effects of intravenous immunoglobulin on IL-4 levels and CD20+ cells in peripheral blood and recurrent rate of infants with wheezing

AIM: To investigate the effects of intravenous immunoglobulin on IL-4 levels and CD20⁺ cells in peripheral blood and the recurrence rate of infants with wheezing. METHODS: IL-4 levels and CD20⁺ cells in peripheral blood of 30 normal infants and 66 infants with wheezing were tested by flow cytometry and ELISA, respectively. The relief time of wheezing and recurrent rate were also recorded. RESULTS: The IL-4 levels and CD20⁺ cells in the wheezing infants were higher than those in controls(P<0.01). The IL-4 levels and CD20⁺ cells in the wheezing infants were decreased after routine treatment but were still higher than those in control infants after treatment. The IL-4 levels and CD20⁺ cells in the wheezing infants were decreased after immunoglobulin treatment and were almost the same as controls after treatment. The relief time of wheezing in the infants with immunoglobulin treatment was shorter than that in the infants with routine treatment(P<0.01), and recurrent rate of immunoglobulin treatment was lower than that of routine treatment(P<0.05). CONCLUSION: The IL-4 levels and CD20⁺ cells in peripheral blood are increased more significantly in infants with wheezing than those in control infants. The mechanisms of wheezing relief and decreasing the recurrent rate by intravenous immunoglobulin are associated with the down-regulation of IL-4 levels and CD20⁺ cells.