【作者】 王军；

【导师】 李亚蕊；

【作者基本信息】 山西医科大学 ， 儿科学， 2007， 硕士

【摘要】 目的:探讨白细胞介素18(Interleukin 18,IL-18)与儿童哮喘急性发作期的关系及其临床意义。方法:对36例哮喘患儿,应用酶联免疫吸附试验,于急性发作期(轻、中、重度各12例)和临床缓解期分别测定IL-18和IgE。正常对照组12例。结果:应用方差分析,在哮喘急性发作期,IL-18浓度值轻度(246±34 pg/ml)、中度(344±40 pg/ml)、重度发作组(470±45 pg/ml)和正常对照组(104±26 pg/ml),4组间有差异(F=195,P＜0.001),多重比较示各组间差别显著(P＜0.05),且随哮喘严重程度的增加IL-18浓度值增高;IgE浓度值轻度(143±34 IU/ml)、中度(240±34 IU/ml)、重度发作组(340±40 IU/ml)和正常对照组(27±19 IU/ml),4组间有差异(F=200,P＜0.001),多重比较示各组间差别显著(P＜0.05),且随哮喘严重程度的增加IgE浓度值增高。采用配对t检验,IL-18浓度值哮喘急性发作期与临床缓解期前后自身对照,两期有显著差异(t=17.48,P＜0.001),IL-18浓度值急性发作期高于临床缓解期。IgE浓度值哮喘急性发作期与临床缓解期前后自身对照,两期有显著差异(t=16.03,P＜0.001),IgE浓度值急性发作期高于临床缓解期。相关性检验显示:急性发作期,血清IL-18与IgE浓度值呈显著正相关(r=0.974,P＜0.01),临床缓解期二者呈正相关(r=0.651,P＜0.01)。结论:哮喘急性发作期IL-18浓度值增高,且与哮喘的严重程度有关,临床缓解期IL-18浓度值降低,IL-18与IgE浓度值呈显著正相关关系。推测其参与气道炎症的诱导,提示血清IL-18浓度值对判断哮喘急性发作程度、儿童哮喘分期有一定临床意义。更多还原

【Abstract】 Objective:To investigate the Serum levels of interleukin(IL)18 in children with bronchial asthma during the stage of acute attack,and to expore the association with asthma and its clinical significance.Methods:The levels of serum IL-18 and IgE were measured by enzymelinked immunosorbent assay(ELISA)in the children(n=36)with asthma during both acute attack and convalescence stage;who were divided into three groups according to the severity of the disease during the stage of acute attack:mild asthma group(n=12)、moderate asthma group (n=12)and severe asthma group(n=12),healthy children(n=12)served as the controls.Results:There were significant differences in levels of serum IL18 in children with bronchial asthma during the stage of acute attack among four groups by oneway ANOVA (F=195,p＜0.001),mild asthma group(246±34 pg/ml),moderate asthma group(344±40 pg/ml), severe asthma group(470±45 pg/ml),healthy children(104±26 pg/ml).Also there were significant differences in levels of serum IgE in children with bronchial asthma during the stage of acute attack among four groups by oneway ANOVA(F=200,p＜0.001),mild asthma group(143±34 IU/ml),moderate asthma group(240±34 IU/ml),severe asthma group(340±40 IU/ml),healthy children(27±19 IU/ml).Further analysis was performed for comparisons among four groups.We found significant differences in levels of serum IL18 and IgE between every two groups(p＜0.05),the serum levels of IL18 and IgE tend to increase as the severity of the disease increased in children with bronchial asthma during the stage of acute attack,by paired t-test,we found significant differences in levels of serum IL18 in the children with asthma between the stage of acute attack and convalescence(t=17.48,p＜0.001).also we found significant differences in levels of serum IgE,in the children with asthma between the stage of acute attack and convalescence(t=16.03,p＜0.001).the levels of serum IL18 and IgE during the stage of acute attack is more higher than there levels during the stage of convalescence.the serum levels of IL18 in the children with asthma during acute attack stage significantly correlated with those of IgE(r=0.974,P＜0.01),and during convalescence stage correlated with those of IgE(r=0.651, P＜0.01).Conclusion:the serum levels of IL18 in the children with bronchial asthma tend to increase as the severity of the disease during the stage of acute attack and reduce during the stage of convalescence,the serum levels of IL18 during acute attack stage significantly correlated with those of IgE.Probably chronic airway inflammation is triggered by a variety of factor,including IL18.Possibly the serum levels of IL18 have some clinical significance in judgement of the severity of asthma during the stage of acute attack and division of stagea bout bronchial asthma.更多还原