论文部分内容阅读
目的通过检测诱导痰中神经生长因子(nerve growth factor,NGF)和白细胞介素-4(IL-4)的表达,探讨NGF和IL-4在小儿咳嗽变异性哮喘中的作用。方法选择2014年1月—2015年9月收治的咳嗽变异性哮喘患儿46例作为观察组,选择同期健康体检儿童46例作为对照组。进行痰诱导,检测诱导痰中细胞分类计数,酶联免疫吸附法和荧光定量PCR分别检测诱导痰中NGF、IL-4水平及诱导痰沉淀细胞中NGF、IL-4 m RNA的表达水平,观察相关性。计量资料组间比较采用t检验,组内比较采用配对t检验,P<0.05为差异有统计学意义。结果观察组诱导痰中嗜酸性粒细胞百分数为(10.2±3.8)%,显著高于对照组(2.7±1.6)%,差异有统计学意义(P<0.05)。观察组诱导痰中NGF和IL-4水平分别为(9.1±2.2)、(266±42)ng/L,均高于对照组的(5.3±1.1)、(153±20)ng/L,差异均有统计学意义(均P<0.05)。观察组诱导痰沉淀细胞中NGF、IL-4 m RNA表达水平分别为(0.567±0.028)、(0.664±0.030),均高于对照组的(0.240±0.012)、(0.165±0.014),差异均有统计学意义(均P<0.05)。观察组治疗后诱导痰中NGF和IL-4表达水平及诱导痰沉淀细胞中NGF、IL-4m RNA的表达水平分别为(6.1±1.2)、(204±36)ng/L、(0.352±0.014)、(0.365±0.014),均明显低于治疗前,差异均有统计学意义(均P<0.05)。诱导痰中嗜酸性粒细胞计数与诱导痰上清中NGF、IL-4浓度呈正相关(r=0.395、0.333)。诱导痰中嗜酸性粒细胞计数与痰沉淀细胞中NGF与IL-4表达水平呈正相关(r=0.432、0.500)。结论嗜酸性粒细胞的浸润和炎性介质NGF、IL-4的升高参与小儿咳嗽变异性哮喘的发生发展过程,在小儿咳嗽变异性哮喘的诊断和治疗中具有一定价值。
Objective To investigate the role of NGF and IL-4 in children with cough-variant asthma by detecting the expression of nerve growth factor (NGF) and interleukin-4 (IL-4) in induced sputum. Methods Forty-six children with cough variant asthma admitted from January 2014 to September 2015 were selected as the observation group and 46 healthy children were selected as the control group. Sputum induction, the detection of induced sputum cell count, enzyme-linked immunosorbent assay and fluorescence quantitative PCR were detected in induced sputum NGF, IL-4 levels and induced sputum sedimentation cells NGF, IL-4mRNA expression levels were observed Correlation. Measurement data were compared between groups using t test, the group was compared using paired t test, P <0.05 for the difference was statistically significant. Results The percentage of induced sputum eosinophils in the observation group was (10.2 ± 3.8)%, which was significantly higher than that in the control group (2.7 ± 1.6)%, the difference was statistically significant (P <0.05). The levels of NGF and IL-4 in induced sputum in observation group were (9.1 ± 2.2) and (266 ± 42) ng / L, respectively, which were higher than those in control group (5.3 ± 1.1) and (153 ± 20) ng / L, All were statistically significant (P <0.05). The expression levels of NGF and IL-4 m RNA in the sputum pelleted cells in the observation group were (0.567 ± 0.028) and (0.664 ± 0.030), respectively, which were significantly higher than those in the control group (0.240 ± 0.012 and 0.165 ± 0.014, respectively) There was statistical significance (all P <0.05). The expression levels of NGF and IL-4 in induced sputum and the levels of NGF and IL-4mRNA in induced sputum sedimentation cells in observation group were (6.1 ± 1.2), (204 ± 36) ng / L and (0.352 ± 0.014 ), (0.365 ± 0.014), respectively, which were significantly lower than those before treatment (all P <0.05). The eosinophil count in induced sputum was positively correlated with the concentration of NGF and IL-4 in induced sputum supernatant (r = 0.395,0.333). The eosinophil count in induced sputum correlated positively with the expression of NGF and IL-4 in sputum sedimentation cells (r = 0.432, 0.500). Conclusion The infiltration of eosinophils and the increase of inflammatory mediators NGF and IL-4 are involved in the development of pediatric cough variant asthma, which is of value in the diagnosis and treatment of pediatric cough variant asthma.