5岁以下喘息儿童鼻咽分泌物嗜酸性粒细胞和IL-17测定的临床意义

Measurement of eosinophils and interleukin-17 in nasopharyngeal secretions of children under 5 years old with wheezing

摘要:

目的：探讨5岁以下喘息儿童鼻咽分泌物中嗜酸性粒细胞(EOS)计数和白介素-17（IL-17）水平在喘息评估中的临床意义。方法：53例5岁以下反复喘息患儿，分为有特应性体质的喘息Ⅰ组27例，非特应性体质的喘息Ⅱ组26例；非感染性疾病术前患儿20例作为对照组，分别收集鼻咽分泌物并处理后，显微镜下计数各组鼻咽分泌物中细胞数，用ELISA方法检测上清液中IL-17水平。结果：喘息Ⅰ组鼻咽分泌物中EOS计数明显高于喘息Ⅱ组和对照组（P＜0.05、P＜0.01)；喘息喘Ⅱ组鼻咽分泌物中EOS计数和对照组比较差异无统计学意义（P＞0.05）；喘息Ⅰ组和喘息Ⅱ组患儿鼻咽分泌物中IL-17表达均高于对照组（P＜0.01），其中喘息Ⅰ组IL-17水平高于喘息Ⅱ组,差异有统计学意义(1 474±974 pg/mL vs 788±132 pg/mL; P＜0.05)；喘息Ⅰ组IL-17水平和EOS呈正相关（r=0.62，P＜0.05)。结论：检测鼻咽分泌物中EOS和IL-17可以作为识别5岁以下有发展为哮喘倾向的喘息儿童的指标，并给予早期临床干预和治疗。［中国当代儿科杂志，2010，12（2）：113-116］

Abstract:

OBJECTIVE: To study the value of eosinophils (EOS) and interleukin-17 (IL-17) in nasopharyngeal secretions in the evaluation of progress of wheezing in children under 5 years old. METHODS: Fifty-three children under five years old who had recurrent wheezing were classified into two groups: wheezing group I with atopic body (n=27) and wheezing group II without atopic body (n=26). Twenty pre-surgical children with non-infectious disease were used as the control group. Nasopharyngeal secretions were collected. Inflammatory cells in nasopharyngeal secretions were counted under the microscope. IL-17 levels in supernatants were measured using ELISA. RESULTS: EOS counts in nasopharyngeal secretions in wheezing group I were significantly higher than those in wheezing group II and the control group (P<0.05, P<0.01, respectively). There were no significant differences in EOS counts between wheezing II and the control groups. The IL-17 levels in both wheezing groups were significantly higher than those in the control group (P<0.01), and the wheezing group I had increased IL-17 levels than wheezing group II (1 474±974 pg/mL vs 788±132 pg/mL; P<0.05). The IL-17 level was positively correlated with the EOS counts in wheezing group I (r=0.62, P<0.05). CONCLUSIONS: EOS counts and IL-17 levels in nasopharyngeal secretions may be used as indices for identifying the tendency to develop asthma in children under 5 years old with wheezing.［Chin J Contemp Pediatr, 2010, 12 (2):113-116］