特应性和非特应性哮喘患儿IL-10和ET-1测定及临床意义

发布时间：2018-02-10 21:36

本文关键词： 支气管哮喘特应性白介素-10（IL-10）血浆内皮素-1（ET-1）免疫球蛋白E（IgE）　出处：《吉林大学》2012年硕士论文　论文类型：学位论文

【摘要】：研究背景和目的:支气管哮喘发病机制复杂，免疫、遗传、环境等多种因素影响着哮喘的发生与发展，已经成为当今世界威胁公共健康最常见的慢性肺部疾病之一，尤其在儿童中。目前关于喘息性疾病的发展历程，有两种发展历程受到广泛关注，主要包括过敏历程和感染历程，其中过敏历程主要是指从变应性皮炎到过敏性鼻炎、支气管哮喘的发展历程。过敏体质与支气管哮喘的关联得到一致认可。本研究通过检测特应性与非特应性哮喘患儿血清白介素-10（IL-10）、血浆内皮素-1（ET-1）及免疫球蛋白E水平，旨在探讨哮喘患儿尤其是特应性哮喘患儿血清IL-10、ET-1的表达情况及临床意义。研究方法:随机选择吉林大学第一医院2010年1月至2010年10月儿科住院患儿，按中华医学会儿科学分会呼吸学组2008年修订的《儿童支气管哮喘诊断与防治指南》及《全球哮喘防治创议》（GINA）诊断标准，，诊断为支气管哮喘患儿60例作为观察对象，同时应用过敏原皮肤点刺试验和血清IgE测定确定患儿的特应性状态，并根据结果分为特应性哮喘组和非特应性哮喘组，特应性组32例，非特应性组28例。32例特应性哮喘患儿中，男性18例，女性14例，年龄范围3～14岁，中位年龄6.4岁；28例非特应性哮喘患儿中，男性15例，女性13例，年龄范围2～13岁，中位年龄7.2岁。并选取同期30名体检正常儿童作为健康对照组，其中男性17例，女性13例，年龄3～14岁，中位年龄6.3岁。应用ELISA酶联免疫吸附试验检测各组血清IL-10、ET-1及IgE的含量。研究结果： 1．哮喘组患儿发作期血清IL-10水平低于缓解期和正常对照组，差异有统计学意义（P 0.05），ET-1和IgE水平明显高于缓解期和正常对照组，差异有统计学意义（P 0.01）。 2．哮喘组患儿缓解期IL-10水平低于对照组，ET-1水平高于对照组，但差异无统计学意义（P0.05），IgE水平高于对照组，两组间差异有统计学意义（P 0.01）。 3．发作期特应性组IL-10水平与非特应性组比较，差异有统计学意义（P 0.05），缓解期特应性组IL-10水平与非特应性组比较，差异无统计学意义（P0.05）；特应性组ET-1、IgE水平在发作期和自身缓解期均高于非特应性组，差异有统计学意义（P 0.01）。结论： 1．哮喘患儿血清中IL-10水平降低，ET-1和IgE水平升高，提示IL-10、ET-1及IgE可能参与了小儿哮喘的病理生理过程。 2．哮喘患儿特应性组较非特应性组血清IL-10、ET-1及IgE水平改变程度更明显，提示IL-10、ET-1及IgE可能与特应性有关。 3．哮喘发作期血清IL-10低水平表达，ET-1及IgE高水平表达，IL-10的水平与ET-1及IgE间分别呈明显负相关，ET-1与IgE呈明显正相关。
[Abstract]:Background and objective: asthma has become one of the most common chronic lung diseases threatening public health in the world because of its complex pathogenesis, immunity, heredity, environment and other factors affecting the occurrence and development of asthma. Especially among children. At present, there are two kinds of development processes of wheezing diseases that have received extensive attention, mainly including allergic process and infection process, among which allergic process mainly refers to allergic dermatitis to allergic rhinitis. The relationship between allergic constitution and bronchial asthma was unanimously recognized. In this study, the levels of serum interleukin-10 (IL-10), plasma endothelin-1 (ET-1) and immunoglobulin E (IgE) were measured in children with atopic and non-atopic asthma. To investigate the expression and clinical significance of IL-10 ET-1 in children with asthma, especially in children with atopic asthma. Methods: pediatric hospitalized children were randomly selected from January 2010 to October 2010 in the first Hospital of Jilin University. According to the guidelines for the diagnosis and treatment of bronchial Asthma in Children, revised in 2008 by the Respiratory Group of the Chinese Academy of Pediatrics, and according to the diagnostic criteria of Global Asthma Prevention and treatment, 60 children with bronchial asthma were diagnosed as subjects of observation. At the same time, the anaphylaxis skin prick test and serum IgE test were used to determine the atopic status of the children. According to the results, they were divided into atopic asthma group and non-atopic asthma group (n = 32), atopic group (n = 32), non-atopic group (n = 28), and non-atopic group (n = 28). There were 18 males, 14 females, and the age range was 314 years. The median age was 6.4 years old and 28 children with non-atopic asthma, 15 males and 13 females, the age ranged from 2 to 13 years. The median age was 7.2 years, and 30 healthy children in the same period were selected as the healthy control group, including 17 males and 13 females, aged 314 years, with a median age of 6.3 years. The levels of IL-10 ET-1 and IgE in serum were detected by ELISA enzyme-linked immunosorbent assay (Elisa). Results of the study:. 1. The level of serum IL-10 in asthmatic group was lower than that in remission group and normal control group, and the difference was statistically significant (P 0.05). The levels of ET-1 and IgE were significantly higher in asthmatic group than in remission stage and normal control group (P < 0.01). 2. The level of IL-10 in asthmatic group was lower than that in control group in remission period, but there was no significant difference between the two groups (P 0.05). The difference between the two groups was statistically significant (P 0.01). 3.Compared with the non-atopic group, the level of IL-10 in the atopic group was significantly higher than that in the non-atopic group (P 0.05), and the IL-10 level in the atopic group in the remission stage was higher than that in the non-atopic group. The level of ET-1 IgE in the atopic group was higher than that in the non-atopic group at the attack stage and the self-remission stage, and the difference was statistically significant (P 0.01). Conclusion:. 1. The serum levels of IL-10 and IgE in asthmatic children decreased, suggesting that IL-10 et-1 and IgE might be involved in the pathophysiological process of asthma in children. 2. The changes of serum IL-10ET-1 and IgE levels in asthmatic children were more obvious than those in non-atopic group, suggesting that IL-10t- ET-1 and IgE might be related to atopic status. 3. The low level of serum IL-10 and the high level of IgE expression of IL-10 were negatively correlated with ET-1 and IgE in asthmatic attack. There was a significant positive correlation between ET-1 and IgE.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R725.6

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