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目的探讨炎症因子IL-4、IL-17、IL-33对小儿哮喘病情的判断价值及其与免疫功能、气道功能的相关关系。方法收集2013年4月-2016年4月在本院接受治疗的哮喘小儿128例,根据病情严重程度分为轻度组47例、中度组50例、重度组31例;另选取50例健康小儿作为正常对照组。采用酶联免疫吸附法(ELISA)测定血清炎症因子含量,采用流式细胞仪测定外周血T淋巴细胞亚群,采用肺功能仪检测小气道功能。结果哮喘患儿血清IL-4、IL-17、IL-33含量高于正常对照组;哮喘患儿的外周血CD_3~+、CD_4~+T淋巴细胞水平及CD_4~+/CD_8~+比值低于正常对照组,CD_8~+T淋巴细胞水平高于正常对照组,哮喘病情越重,CD_3~+、CD_4~+T淋巴细胞水平及CD_4~+/CD_8~+ 比值越低,CD_8~+ T淋巴细胞水平越高;哮喘患儿的最大呼气中段流量(MMEF)、用力呼出50%肺活量的呼气流量(MEF50)、用力呼出25%肺活量的呼气流量(MEF25)低于正常对照组,上述差异均有统计学意义(P<0.05)。结论炎症因子IL-4、IL-17、IL-33含量是小儿哮喘的血清学特征之一,可作为病情判断的客观指标。
Objective To investigate the diagnostic value of inflammatory cytokines IL-4, IL-17 and IL-33 in children with asthma and their relationship with immune function and airway function. Methods A total of 128 children with asthma who were treated in our hospital from April 2013 to April 2016 were divided into mild group (n = 47), moderate group (n = 50) and severe group (n = 31) Children as a normal control group. Serum levels of inflammatory cytokines were determined by enzyme-linked immunosorbent assay (ELISA). T lymphocyte subsets in peripheral blood were measured by flow cytometry. Small pulmonary function was detected by pulmonary function test. Results Serum levels of IL-4, IL-17 and IL-33 in asthmatic children were significantly higher than those in normal controls. The levels of CD_3 ~ +, CD_4 ~ + T lymphocytes and CD_4 ~ + / CD_8 ~ + In the normal control group, the level of CD_8 ~ + T lymphocytes was higher than that of the normal control group. The more the asthma was, the lower the CD_3 ~ +, CD_4 ~ + T lymphocytes and the ratio of CD_4 ~ + / CD_8 ~ (MEF50), forced exhaled 25% expiratory volume of expiratory flow (MEF25) was lower than that of the normal control group (P <0.05) The differences were statistically significant (P <0.05). Conclusion The inflammatory cytokines IL-4, IL-17, IL-33 levels are one of the serological features of pediatric asthma and can be used as an objective indicator of the disease.