CAJ | 학술논문

目的：通过对儿童哮喘支气管肺泡灌洗液成分分析探讨其发病机制。方法：应用酶联免疫吸附实验（ELISA）方法，对哮喘（29例）、支气管肺炎（26例）和对照组（20例）共75例患儿的支气管肺泡灌洗液进行细胞成分分析及上清液Ig E、IL-12、IL-4、IL-13浓度测定。结果：哮喘组支气管肺泡灌洗液嗜酸性粒细胞为3．3％（1．0％～9．0％），上皮细胞2．9％（0．5％～9．8％），IgE为（98．76±15．65）ng／L ，IL-4为（17．89±3．65）ng／L ，IL-13为（6．75±0．87）ng／L ，与支气管肺炎组和对照组相比明显增高，差异有非常显著意义（ P＜0．01）；哮喘组IL-12为（2．12±0．76）ng／L ，与支气管肺炎组和对照组相比明显降低，差异有非常显著意义（P＜0．01）；支气管肺炎组中性粒细胞明显增多。结论：哮喘患儿支气管肺泡灌洗液以嗜酸性粒细胞和上皮细胞增多及Ig E增高为其特征；哮喘患儿支气管肺泡灌洗液IL-4、IL-13浓度增高，IL-12浓度降低，提示T h1／T h2失衡是哮喘重要发病机制；支气管肺泡灌洗液检查可为哮喘患儿诊断提供有益线索。
목적：통과대인동효천지기관폐포관세액성분분석탐토기발병궤제。방법：응용매련면역흡부실험（ELISA）방법，대효천（29례）、지기관폐염（26례）화대조조（20례）공75례환인적지기관폐포관세액진행세포성분분석급상청액Ig E、IL-12、IL-4、IL-13농도측정。결과：효천조지기관폐포관세액기산성립세포위3．3％（1．0％～9．0％），상피세포2．9％（0．5％～9．8％），IgE위（98．76±15．65）ng／L ，IL-4위（17．89±3．65）ng／L ，IL-13위（6．75±0．87）ng／L ，여지기관폐염조화대조조상비명현증고，차이유비상현저의의（ P＜0．01）；효천조IL-12위（2．12±0．76）ng／L ，여지기관폐염조화대조조상비명현강저，차이유비상현저의의（P＜0．01）；지기관폐염조중성립세포명현증다。결론：효천환인지기관폐포관세액이기산성립세포화상피세포증다급Ig E증고위기특정；효천환인지기관폐포관세액IL-4、IL-13농도증고，IL-12농도강저，제시T h1／T h2실형시효천중요발병궤제；지기관폐포관세액검사가위효천환인진단제공유익선색。
Objective:To explore the pathogenesis of pediatric asthma ,we analyzed the pediatric asthma bronchoalveo-lar lavage fluid including cell composition and cytokine level .Methods:Using ELISA ,we measured IgE ,IL-12 ,IL-4 and IL-13 and counting the cell number in bronchoalveolar lavage fluid of 75 patients including asthma(n=29) ,broncho-pneumonia (n=26) ,control (n=20) .Results:In the group of asthma ,eosnophils was 3 .3% (1 .0% ~9 .0% ) ,epitheli-al cell 2 .9% (0 .5% ~9 .8% ) ,IgE was (98 .76 ± 15 .65)ng/L ,IL-4 was (17 .89 ± 3 .65)ng/L ,IL-13 was (6 .75 ± 0 .87) ng/L .That was significantly higher than the group of bronchopneumonia and control(P<0 .01) .IL-12(2 .12 ± 0 .76) ng/L in the group of asthma was significantly lower than the group of bronchopneumonia and control(P<0 .01) .How-ever ,neutrophil was obviously increased in the bronchopneumonia .Conclusion:Pediatric asthma bronchoalveolar lavage fluid was characterized with the increase of eosnophils ,epithelial cell and IgE .The concentration of IL-4 and IL-13 in-creased ,but the concentration of IL-12 decreased in the bronchoalveolar lavage fluid of pediatric asthma .It is sugges-ted that the unbalance of Th1/Th2 is of importance in the pathogenesis of pediatric asthma .