CAJ | 학술논문

目的：探讨外周血Th1细胞因子γ干扰素（IFN-γ）、Th2细胞因子白细胞介素-4（IL-4）及TIgE的水平在肺炎支原体肺炎患儿发病中的作用以及肺功能变化的临床意义。方法选择肺炎支原体肺炎患儿64例，其中喘息组27例，非喘息组37例，健康体检儿童20例为研究对象。用ELISA法测定Th1细胞因子IFN-γ、Th2细胞因子IL-4。荧光酶标法测定血清中TIgE的水平，肺炎支原体肺炎患儿行肺功能检测。结果（1）肺炎支原体肺炎喘息组、非喘息组与对照组三者比较应用方差分析，血清IL-4、IFN-γ、IFN-γ/IL-4及TIgE水平比较差异均有显著性（P均＜0.05）。（2）肺炎支原体肺炎喘息组与非喘息组常规肺功能及小气道功能比较差异均有显著性（P均＜0.000）。（3）肺炎支原体肺炎患儿血清IL-4与IFN-γ水平经Pearson相关分析呈正相关（r＝0.780，P＝0.000）。（4）肺炎支原体肺炎患儿血清IL-4与TIgE水平经Pearson相关分析呈正相关（r＝0.531，P＝0.000）。（5）肺炎支原体肺炎患儿血清IL-4、IFN-γ水平经Pearson相关分析与肺功能FEV1/%、PEF%及V50%、V25%均呈负相关（r 分别为-0.490、-0.377、-0.296、-0.407，P 均＜0.05）。结论肺炎支原体肺炎患儿Th1/Th2值下降，Th2细胞占优势，患儿存在免疫失调；肺炎支原体肺炎患儿肺功能改变主要表现为阻塞性、限制性或混合性通气功能障碍。
목적：탐토외주혈Th1세포인자γ간우소（IFN-γ）、Th2세포인자백세포개소-4（IL-4）급TIgE적수평재폐염지원체폐염환인발병중적작용이급폐공능변화적림상의의。방법선택폐염지원체폐염환인64례，기중천식조27례，비천식조37례，건강체검인동20례위연구대상。용ELISA법측정Th1세포인자IFN-γ、Th2세포인자IL-4。형광매표법측정혈청중TIgE적수평，폐염지원체폐염환인행폐공능검측。결과（1）폐염지원체폐염천식조、비천식조여대조조삼자비교응용방차분석，혈청IL-4、IFN-γ、IFN-γ/IL-4급TIgE수평비교차이균유현저성（P균＜0.05）。（2）폐염지원체폐염천식조여비천식조상규폐공능급소기도공능비교차이균유현저성（P균＜0.000）。（3）폐염지원체폐염환인혈청IL-4여IFN-γ수평경Pearson상관분석정정상관（r＝0.780，P＝0.000）。（4）폐염지원체폐염환인혈청IL-4여TIgE수평경Pearson상관분석정정상관（r＝0.531，P＝0.000）。（5）폐염지원체폐염환인혈청IL-4、IFN-γ수평경Pearson상관분석여폐공능FEV1/%、PEF%급V50%、V25%균정부상관（r 분별위-0.490、-0.377、-0.296、-0.407，P 균＜0.05）。결론폐염지원체폐염환인Th1/Th2치하강，Th2세포점우세，환인존재면역실조；폐염지원체폐염환인폐공능개변주요표현위조새성、한제성혹혼합성통기공능장애。
Objective To investigate the influence of the peripheral blood of Th1 cytokine interferon-γ (IFN-γ), Th2 cytokine interleukin-4 (IL-4) and the level of TIgE in the pathogenesis of the children with mycoplasma pneumoniae pneumonia(MPP) and clinical significance of the change of pulmonary function. Methods The study involved 64 cases with MPP from Department of Pediatrics, the Third Affiliated Hospital of Inner Mongolia Medical College from March 2012 to March 2013.The patients were divided into 3 groups. There were 27 cases in asthma group, 37 cases in non-asthma group, the healthy control group included 20 healthy children. IFN-γ and IL-4 were detected by ELISA and serum total IgE(TIgE) was assay with the Pharmacia CAP system. The children with MPP performed the pulmonary function testing. Results (1)After being analysis of variance of data, the level of IL-4, IFN-γ, IFN-γ/IL-4 and TIgE had significant statistics difference (P<0.05) in the asthma group, non-asthma group and control group. (2)The pulmonary function and small airway function in asthma group and non-asthma group had significant statistics difference (P<0.000). (3)Serum IL-4 and IFN-γ levels had positive correlation(r=0.780, P=0.000) by Pearson correlation analysis. (4)There was a positive correlation between IL-4 and TIgE in the MPP patients (r=0.531, P=0.000). (5)Study show a negative correlation between serum IL-4 and IFN-γ levels and pulmonary function FEV1/%, PEF%, V50% and V25% (r=-0.490,-0.377, -0.296, -0.407; P<0.05). Conclusion The value of the Th1/Th2 is decline and the Th2 cells shifts in MPP patient, which may lead to immune disorders. Obstructive, restrictive or combined ventilation dysfunction were the mainly.