炎症相关细胞和IL-10在3岁以下儿童急性下呼吸道感染外周血中的表达

发布时间：2018-04-14 14:38

本文选题：儿童 + 下呼吸道感染　；参考：《苏州大学》2012年硕士论文

【摘要】：目的：研究CD4~+CD25~+FoxP3~+T调节细胞、白细胞介素-10（Interleukin-10，IL-10）、嗜酸性粒细胞和嗜碱性粒细胞在3岁以下儿童不同临床特征急性下呼吸道感染（Lower respiratory tract infection，LRTI）外周血的不同表达。评价其在有喘息表现LRTI患儿中的价值，并探讨有喘息症状的LRTI与支气管哮喘的内在关联。方法：选取苏州大学附属儿童医院呼吸科2011年8月～2012年1月间收治的113例住院前未使用过糖皮质激素的LRTI患儿，根据以往有无医生诊断为特应性皮炎、入院时是否有喘息和哮喘预测指数进行分组，并选取19例健康儿童为对照组。入院后进行多病原学检测，并留取患儿外周血标本，分别采用流式细胞仪检测CD4~+CD25~+FoxP3~+Treg的比例、酶联免疫吸附试验（ELISA）检测IL-10水平、血细胞分析仪检测患儿嗜酸性粒细胞和嗜碱性粒细胞的比例。结果：（1）LRTI患儿以病毒感染为主，呼吸道合胞病毒感染占首位，LRTI患儿外周血嗜碱性粒细胞比例、CD4~+CD25~+FoxP3~+Treg比例和IL-10表达水平要高于对照组，而嗜酸性粒细胞比例要低于对照组。差异均有统计学意义（P0.05）。（2）在所有LRTI患儿中，有特应性皮炎史患儿外周血CD4~+CD25~+FoxP3~+Treg比例低于无特应性皮炎史患儿，差异有统计学意义（P0.05）；有特应性皮炎史患儿外周血嗜碱性粒细胞比例、嗜酸性粒细胞比例和IL-10表达水平与无特应性皮炎史患儿比较差异无统计学意义（P0.05）。（3）在所有LRTI患儿中，喘息患儿外周血IL-10含量高于无喘息患儿，差异有统计学意义（P0.05）；喘息患儿外周血嗜酸性粒细胞比例、嗜碱性粒细胞比例和CD4~+CD25~+FoxP3~+Treg比例与无喘息患儿比较差异无统计学意义（P0.05）。（4）在所有入选儿童中，有特应性皮炎史喘息组、有特应性皮炎史非喘息组、无特应性皮炎史喘息组和无特应性皮炎史非喘息组患儿外周血嗜酸性粒细胞比例均低于对照组，差异具统计学意义（P0.0033），其他各组间外周血嗜酸性粒细胞比例两两比较差异均无统计学意义（P0.0033）；有特应性皮炎史喘息组和有特应性皮炎史非喘息组患儿外周血嗜碱性粒细胞比例均高于对照组，差异具统计学意义（P0.0033），其他各组间嗜碱性粒细胞比例两两比较差异均无统计学意义（P0.0033）；哮喘预测指数阳性患儿外周血CD4~+CD25~+FoxP3~+Treg的比例要高于对照组但低于其他各组，对照组儿童外周血CD4~+CD25~+FoxP3~+Treg比例低于其他各组，差异具统计学意义（P0.0033），其余各组间CD4~+CD25~+FoxP3~+Treg比例两两比较差异均无统计学意义（P0.0033）；哮喘预测指数阳性患儿和喘息有特应性皮炎史患儿外周血IL-10含量均高于健康对照组，差异有统计学意义（P0.0033），其他各组间外周血IL-10含量两两比较差异均无统计学意义（P0.0033）。结论：CD4~+CD25~+FoxP3~+Treg、IL-10、嗜酸性粒细胞和嗜碱性粒细胞均参与了儿童LRTI的发病机制；LRTI时外周血IL-10含量较高可能与喘息发生有关；LRTI时外周血CD4~+CD25~+FoxP3~+Treg比例升高是机体的免疫防御表现的一部分，哮喘预测指数阳性患儿发生急性喘息性LRTI时，，外周血CD4~+CD25~+FoxP3~+Treg比例升高受损，CD4~+CD25~+FoxP3~+Treg可作为哮喘预测指数阳性儿童早期喘息治疗靶点。
[Abstract]:Objective: To study the regulation of CD4~+CD25~+FoxP3~+T cells, interleukin -10 (Interleukin-10, IL-10), eosinophils and basophils in children under the age of 3 different clinical features of acute lower respiratory tract infection (Lower respiratory tract infection, LRTI) expression in peripheral blood. To evaluate the performance of LRTI in asthmatic children. The value, and to explore the relationship between LRTI and asthma have wheezing symptoms.
Methods: from August 2011 to January 2012 in the Department of respiration of Children's Hospital Affiliated to Suzhou University from 113 inpatients before not used glucocorticoid LRTI patients, according to previous doctors diagnosed with atopic dermatitis, whether there is wheezing and asthma predictive index of group, and selected 19 cases of healthy children as control group. After admission of detection of pathogens, and take the children's peripheral blood specimens were detected by flow cytometry CD4~+CD25~+FoxP3~+Treg ratio, enzyme-linked immunosorbent assay (ELISA) detection of IL-10 level detection in children with blood cell analyzer of eosinophils and basophils.
Results: (1) LRTI patients with viral infection of respiratory syncytial virus infection first, LRTI patients peripheral blood basophils in proportion, the expression level of CD4~+CD25~+FoxP3~+Treg and the ratio of IL-10 was higher than that of the control group, while the proportion of eosinophils is lower than the control group. The differences were statistically significant (P0.05).
(2) in all LRTI patients, a history of atopic dermatitis in peripheral blood of children with CD4~+CD25~+FoxP3~+Treg was lower than that of non atopic dermatitis in children, the difference was statistically significant (P0.05); a history of atopic dermatitis in children with peripheral blood basophils, eosinophils ratio and IL-10 expression with no history of atopic dermatitis in children with no significant difference (P0.05).
(3) in all children with LRTI, the content of IL-10 in peripheral blood of children with wheezing and wheezing were higher than those without, the difference was statistically significant (P0.05); wheezing in children with peripheral blood eosinophil percentage, no significant basophilic cell proportion and CD4~+CD25~+FoxP3~+Treg ratio with no wheezing difference (P0.05).
(4) in all the children, have a history of atopic dermatitis in wheezing group, atopic dermatitis in the history of non wheezing group, non atopic asthmatic group and no history of atopic dermatitis in children with history of non wheezing group peripheral blood eosinophil percentage was lower than the control group, the difference was statistically significant (P0.0033), the difference between the other groups of peripheral blood eosinophils proportion 22 had no statistical significance (P0.0033); a history of atopic dermatitis in wheezing group and atopic dermatitis in the history of non wheezing group in peripheral blood neutrophils alkaline ratio were higher than the control group, the difference was statistically significant (P0.0033), the difference between the other groups of basophils in the proportion of 22 were not statistically significant (P0.0033); Asthma Predictive Index of children with positive peripheral blood CD4~+CD25~+FoxP3~+Treg ratio was higher than that of the control group but lower than the other groups, the control group in peripheral blood of children CD4~+CD25~+FoxP3~ The +Treg ratio is lower than the other groups, the difference was statistically significant (P0.0033), CD4~+CD25~+FoxP3~+Treg ratio of 22 other groups showed no significant difference (P0.0033); Asthma Predictive Index positive children with atopic dermatitis and wheezing history in children with peripheral blood IL-10 content were higher than that of the control group, the difference was statistically significant (P0.0033). Other groups of IL-10 in peripheral blood of 22 showed no significant difference (P0.0033).
Conclusion: CD4~+CD25~+FoxP3~+Treg, IL-10, the pathogenesis of eosinophils and basophils are involved in childhood LRTI; peripheral blood IL-10 content may be associated with wheezing LRTI; LRTI increased the proportion of peripheral blood CD4~+CD25~+FoxP3~+Treg is a part of the body's immune defense performance, predictive index positive children with acute asthma asthmatic LRTI, peripheral blood CD4~+CD25~+FoxP3~+Treg increased damage, CD4~+CD25~+FoxP3~+Treg can be used as a predictive index of early wheezing asthma treatment target positive children.

【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R725.6

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