难治性肺炎支原体肺炎患儿支气管肺泡灌洗液中IL-4及INF-γ水平的研究

Levels of interleukin-4 and interferon-gamma in the bronchoalveolar lavage fluid of children with refractory Mycoplasma pneumoniae pneumonia

摘要:

目的：检测难治性肺炎支原体肺炎（RMPP）患儿支气管肺泡灌洗液（BALF）中IL-4、INF-γ水平，探讨RMPP患儿病变局部Th1、Th2型细胞因子水平的变化及其意义。方法：选择RMPP患儿（42例）为研究对象。根据是否有湿疹、过敏性鼻炎、荨麻疹及相关过敏性疾病家族史等将42例RMPP患儿分为特应性组（11例）和非特应性组（31例）。以同期因支气管异物住院、异物取出4周后纤维支气管镜复查的患儿为对照组（12例）。对RMPP患儿及对照患儿BALF中细胞学成分进行分析，并采用ELISA方法检测BALF中IL-4、INF-γ水平。结果：与对照组比较，RMPP组患儿BALF中细胞总数上升（P0.05）。结论：RMPP患儿BALF细胞数显著增加，尤以中性粒细胞为甚。RMPP患儿BALF中INF-γ、IL-4水平明显升高，但INF-γ/IL-4比值无变化，提示RMPP患儿病变局部炎症反应明显，但尚不能证实RMPP患儿存在Th2占主导的炎症反应。

Abstract:

OBJECTIVE: To measure levels of interleukin-4 (IL-4) and interferon-gamma (INF-γ) in the bronchoalveolar lavage fluid (BALF) of children with refractory Mycoplasma pneumoniae pneumonia (RMPP), and to investigate changes in local Th1-Th2-type cytokine levels in children with RMPP and their significance. METHODS: A total of 42 children with RMPP were divided into atopic (n=11) and non-atopic groups (n=31) according to whether they had eczema, allergic rhinitis, urticaria, and family history of allergic disease. The study also included a control group of 12 children with bronchial foreign bodies who underwent foreign body removal and were re-examined by fiberoptic bronchoscopy four weeks later. The different cells in BALF from all children were analyzed, and the levels of IL-4 and INF-γ in BALF were measured using enzyme-linked immunosorbent assay. RESULTS: Compared with the control group, the total number of cells in BALF from children with RMPP increased significantly (P0.05). CONCLUSIONS: Significant increase in cell numbers, especially neutrophils, as well as IL-4 and INF-γ levels, can be seen in BALF from children with RMPP, but there is no change to the INF-γ/IL-4 ratio. This indicates a significant local inflammatory response in children with RMPP, but there is no evidence of Th2-dominated inflammatory response.