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目的探讨5岁以下喘息儿童外周血IL-10和血清总IgE在不同临床表型中的表达及其临床意义。方法随机选取2010年12月-2011年4月于本院就诊的5岁以下反复喘息患儿76例,分为有特应质高危因素的喘息Ⅰ组和无特应质高危因素的喘息Ⅱ组;健康对照组为同期本院儿童保健部体检的健康儿童23例。采用ELISA法测定3组患儿外周血IL-10与总IgE水平。结果喘息Ⅰ组、喘息Ⅱ组IL-10水平均高于健康对照组(Pa<0.01),喘息Ⅰ组IL-10水平高于喘息Ⅱ组,差异有统计学意义(P<0.05)。喘息Ⅰ组总IgE水平明显高于喘息Ⅱ组和健康对照组,差异有统计学意义(Pa<0.01),喘息Ⅱ组总IgE水平和健康对照组之间差异无统计学意义(P>0.05)。喘息Ⅰ组血清IL-10水平与总IgE水平呈正相关(r=0.726,P<0.01),喘息Ⅱ组和健康对照组血清IL-10水平与总IgE水平均无相关性(r=0.043、0.048,Pa>0.05)。结论对5岁以下不能完成呼吸道激发试验和变应原测试的喘息患儿,检测血清IL-10及总IgE水平可区分不同临床表型,可为儿童哮喘的早期临床干预提供一定依据。
Objective To investigate the expression of IL-10 and total serum IgE in peripheral blood of patients with wheeze under 5 years old in different clinical phenotypes and its clinical significance. Methods A total of 76 children with recurrent wheeze below 5 years of age who were admitted to our hospital from December 2010 to April 2011 were randomly divided into two groups: asthmatic group Ⅰ with special risk factors and asthmatic group Ⅱ with no special risk factors ; Healthy control group for the same period in our hospital child health check-up of 23 healthy children. The levels of IL-10 and total IgE in peripheral blood of three groups were measured by ELISA. Results The levels of IL-10 in asthmatic group Ⅰ and asthmatic group Ⅱ were significantly higher than those in healthy control group (P <0.01). The level of IL-10 in asthmatic group Ⅰ was higher than that in asthmatic group Ⅱ (P <0.05). The level of total IgE in wheezing group Ⅰ was significantly higher than that in wheezing Ⅱ group and healthy control group (P <0.01), there was no significant difference between total whey IgE level and healthy control group (P> 0.05) . There was a positive correlation between serum IL-10 level and total IgE level in asthmatic group Ⅰ (r = 0.726, P <0.01). There was no correlation between serum IL-10 level and total IgE level in asthmatic group Ⅱ and healthy controls (r = 0.043,0.048 , Pa> 0.05). Conclusion Children with wheeze below 5 years old who can not complete respiratory provocation test and allergen test can detect different serum levels of IL-10 and total IgE in different clinical phenotypes, which may provide some evidences for early clinical intervention in children with asthma.