目的：探讨哮喘患儿体内嗜酸性粒细胞(eosinophil,EOS)、免疫球蛋白E(IgE)、白介素4(IL-4)及γ干扰素(IFN-γ)水平的检测及临床意义,为临床疾病的诊断和治疗提供依据。方法抽选湖北省鄂州市鄂钢医院2012年11月至2013年6月收治的95例哮喘患儿(哮喘组,其中急性发作期47例、缓解期48例),并抽选同期在本院体检的79例健康患者为对照研究(健康组),采用肺功能仪测定两组的肺功能,并采用痰液诱导、酶联免疫吸附法( ELISA)分别测定患儿痰液中的EOS百分率及血清中IgE、IL-4、IFN-γ水平。结果哮喘组患儿的1秒用力呼气容积(FEV1)/用力肺活量(FVC)的比值(FEV1%)为(69.67±6.63)%,明显低于健康组的(102.27±11.93)%,差异具有统计学意义(t=22.750,P<0.001)；哮喘组患儿的FEV1占预计值百分比为(70.45±9.62),明显低于健康组的(90.13±6.34),差异有统计学意义(t=15.582,P<0.001)。哮喘组患儿的痰EOS百分率、血清中IgE、IL-4水平均高于健康组(t值分别为321.962、82.644、76.913,均P<0.05),哮喘组患儿的IFN-γ水平明显低于健康组(t=30.207,P<0.001)。急性发作期哮喘患儿的痰EOS百分率及血清中IgE、IL-4水平均高于缓解期哮喘患儿的(t值分别为15.752、40.762、31.162,均P<0.05),急性发作期哮喘患儿的IFN-γ水平明显低于缓解期哮喘患儿的(t=35.892,P<0.05)。结论血清中IL-4、IgE水平及痰液中EOS百分率升高、血清IFN-γ水平降低,与哮喘的发生、发展密切相关,对其治疗及病情判断具有重要价值。%Objective To detect the levels of eosinophil (EOS), IgE, IL-4 and IFN-γ in children with asthma and explore their clinical significance, so as to provide basis for clinical diagnosis and treatment of the disease. Methods Totally 95 children with asthma admitted in Ezhou of Hubei Province Egang Hospital from November 2012 to June 2014 were selected ( asthma group, including 47 cases at acute exacerbation phase and 48 cases at remission phase),and 79 patients undergoing health medical examination in the hospital at the same period were selected ( healthy group) . The lung function was measured in both groups by lung function instrument, and sputum inductin and enzyme linked immunosorbent assay ( ELISA) were used for the determination of EOS percentage in sputum, IGE, IL-4 and IFN-γlevels. Results FEV1 % in the asthma group ( 69. 67 ± 6. 63%) was significantly lower than that in the healthy group ( 102. 27 ± 11. 93%), and the difference was significant (t=22. 750, P<0. 001), and percentage of FEV1 of expected value in the asthma group (70.45 ±9.62) was lower than that in the healthy group (90.13 ±6.34) with significant difference (t=15.582,P<0.001). Sputum EOS percentage, serum IgE and IL-4 levels in the asthma group were higher than those in the healthy group (t value was 321. 962, 82. 644 and76.913,respectively,allP<0.05),butIFN-γ levelwassignificantlylower(t=30.207,P<0.001). SputumEOSpercentage, serum IgE and IL-4 levels in asthma children at acute exacerbation phase were higher than those of children at remission phase ( t value was 15.752, 40.762 and 31. 162, respectively, all P <0. 05), but IFN-γ level was significantly lower at acute exacerbation phase (t =35. 892,P<0. 05). Conclusion The high levels of IL-4 and IgE, high EOS percentage in sputum, and low level of serum IFN-γ are closely related with the occurrence and development of asthma, which are important in treatment and judging disease.
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