摘要
目的本研究旨在分析重症肺炎患儿支气管肺泡灌洗液(BALF)中肝素结合蛋白和辅助性T淋巴细胞1(Th1)/Th2型细胞因子的变化及临床意义。方法选择2018年1月至2020年6月在该院诊治的90例肺炎患儿为肺炎组,其中包括49例轻中度感染患儿和41例重症感染患儿,另选取30例同期到该院取支气管异物但无肺部炎症的患儿作为对照组。采用流式细胞分析仪检测患儿BALF中Th1/Th3型细胞因子包括:白细胞介素(IL-2)、干扰素-γ(IFN-γ)、IL-4和IL-6的表达水平及免疫荧光干式定量法检测肝素结合蛋白(HBP)的表达水平,并计算各组患儿INF-γ/IL-4比值,分析各指标的临床意义。结果与对照组相比,肺炎组的BALF中辅助性T细胞因子IL-2、IFN-γ、IL-4和IL-6及肝素结合蛋白(HBP)的表达水平显著升高,差异具统计学意义(P<0.05);其中重症肺炎组患儿较轻中度肺炎组患儿BALF中IL-2[(6.12±2.08)pg/mL vs.(2.81±0.9)pg/mL]、IFN-γ[(27.26±13.26)pg/mL vs.(12.99±4.03)pg/mL]和IL-6[(43.32±25.16)pg/mL vs.(18.59±8.55)pg/mL]的表达水平升高,且差异具有统计意义(P<0.05),而两组患儿BALF中IL-4的表达水平未见明显差异,差异无统计学意义(P>0.05);与对照组相比,肺炎组患儿INF-γ/IL-4比值明显增高,差异有统计学意义(P<0.01);其中,重症肺炎组患儿的INF-γ/IL-4比值较轻中度肺炎患儿降低,差异有统计学意义(P<0.01)。结论重症肺炎患儿BALF中Th1/Th2型细胞因子IL-2、IFN-γ、IL-4和IL-6及肝素结合蛋白(HBP)的表达水平显著增加,提示重症肺炎患儿存在免疫功能的紊乱;且重症肺炎组患儿的INF-γ/IL-4比值较轻中度肺炎患儿降低,提示重症肺炎患儿存在Th1/Th2型细胞因子平衡失调,对评估患儿肺部炎症情况及免疫治疗具一定的指导意义。
Objective To analyze the changes and clinical significance of heparin binding protein(HBP)and Helper T Lymphocyte1(Th1)/Th2 related cytokines in bronchoalveolar lavage fluid(BALF)of children with severe pneumonia.Methods A total of 90 children with pneumonia treated in Guizhou Guiyang Maternal and Child Health Hospital from January 2018 to June 2020 were selected as pneumonia group,including 49 children with mild to moderate infection and 41 cases with severe infection,and during the same period 30 children withbronchial foreingn but no lung inflarmmation any lung diseases were treaeted as the control group.The flow cytometry was used to detect the levels of helper T cytokines[interleukin(IL-2),interferon-γ(IFN-γ),IL-4 and IL-6]in children's BALF and the expression of HBP was detected by immunofluorescence dry quantitative method.Finally,the ratio of INF-γ/IL-4 in each group was calculated to analyze the clinical significance.Results Compared with the control group,the levels of helper T cytokines IL-2,IFN-γ,IL-4,IL-6 and HBP in BALF of children with pneumonia were significantly increased,and the differences were statistically significant(P<0.05).The levels of IL-2[(6.12±2.08)pg/mL vs.(2.81±0.9)pg/mL],IFN-γ[(27.26±13.26)pg/mL vs.(12.99±4.03)pg/mL]and IL-6[(43.32±25.16)pg/mL vs.(18.59±8.55)pg/mL]in the severe pneumonia group were significantly higher than those in the mild to moderate pneumonia group,and the differences were statistically significant(P<0.05).However,there was no significant difference in the level of IL-4 between the two groups(P>0.05).Compared with the control group,the ratio of INF-γ/IL-4 in the pneumonia group was significantly higher,and the difference was statistically significant(P<0.01).Among them,the ratio of INF-γ/IL-4 in severe pneumonia group was significantly lower than that in mild to moderate pneumonia group,and the difference was statistically significant(P<0.01).Conclusion The levels of helper T cytokines IL-2,IFN-γ,IL-4,IL-6 and HBP in BALF of children with severe pneumonia are significantly increased,suggesting that there is immune dysfunction in children with severe pneumonia.In addition,the ratio of INF-γ/IL-4 in severe pneumonia group is lower than that in mild to moderate pneumonia group,suggesting that there is imbalance of Th1/Th2 in children with severe pneumonia,Th2 related cytokines are dominant,and the immune status of children with severe pneumonia shifts to Th2 status.Besides,the expressions of IL-2,IFN-γ,IL-6 and HBP in BALF of children with pneumonia is positively correlated with the severity of pneumonia,providing guidance for the evaluation of lung inflammation and immunotherapy.
作者
梁璐
刘艺清
渠巍
陈敏
胡雷
宋晓梅
LIANG Lu;LIU Yiqing;QU Wei;CHEN Min;HU Lei;SONG Xiaomei(Department of Clinical Laboratory,Guizhou Guiyang Maternal and Child Health Hospital,Guiyang,Guizhou 550003,China)
出处
《国际检验医学杂志》
CAS
2021年第20期2487-2490,2495,共5页
International Journal of Laboratory Medicine
基金
黔科合LH字[2015]7029号。
