中国实用儿科杂志

中国实用儿科杂志

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地塞米松、γ-干扰素对毛细支气管炎患儿免疫调节作用的观察

李桂花;张慧娟   

  1. 青岛市第八人民医院(266100)
  • 收稿日期:2004-12-10 修回日期:2005-02-20 出版日期:2005-06-25 发布日期:2005-06-25

Dexamethasone and IFN-γ on the function of TH1/TH2 in children with lower respiratory tract infections.

Li Guihua,Zhang Huijuan.   

  1. The Eighth Hospital of Qingdao,Shandong 266100,China
  • Received:2004-12-10 Revised:2005-02-20 Online:2005-06-25 Published:2005-06-25

摘要： 目的 观察地塞米松、γ-干扰素对毛细支气管炎患儿T细胞细胞免疫和T细胞体液免疫比值(TH1/TH2)的作用。方法将60例2002年11月至2004年4月在青岛市第八人民医院儿科住院的毛细支气管炎患儿，按入院顺序分成地塞米松组和γ-干扰素组，并选择15例健康婴儿为正常对照组。检测毛细支气管炎患儿治疗前血清IgE水平及细胞因子IFN-γ、IL-4水平，然后分别用地塞米松、γ-干扰素治疗，出院时复查血清IgE、IFN-γ及IL-4水平。结果 正常对照组和毛细支气管炎组血清IgE水平及细胞因子IFN-γ、IL-4、IFN-γ/IL-4水平差异有非常显著意义(P<0.001)。γ-干扰素组和地塞米松组治疗前血清IgE和细胞因子IFN-γ、IL-4、IFN-γ/IL-4差异均无显著性意义(P>0.05),但治疗后,以上指标差异均有非常显著意义(P<0.001)。出院后随访12个月，统计喘息反复发生的例数，γ-干扰素组3例，地塞米松组10例，经卡方检验差异有显著意义(P<0.05)。结论 毛细支气管炎患儿血清IgE水平高，TH1/TH2失衡。地塞米松短期内可起到抗炎、平喘作用，止喘起效快，但TH1/TH2治疗前后无差异，反复感染、喘息反复出现、容易发展成婴幼儿哮喘。


Abstract Objective To observe the effect of dexamethasone and IFNγ on the function of TH1/TH2 in lower respiratory tract infections.Methods Sixty patients with lower respiratory tract infections were divided randomly into 2 groups:group I with dexamethasone treatment,group II with IFNγ treatment.Normal group of 15 cases was as control.Serum levels of IgE,IFNγ and IL4 were detected before and after treatment.Results Compared with normal control,there was significant difference in the serum level of IgE,IFNγ,IL4,IFNγ/IL4 in group Ⅰ and group Ⅰ,P<0.001.There was no difference in the serum level of IgE,IFNγ,IL4,IFNγ/IL4 between group I and group Ⅱ before treatment(P>0.05).But there was significant difference after treatment(P<0.001).After being followed up for 12 months,3 cases suffered from asthma in group Ⅰ,10 cases in group Ⅱ.There were outstanding meanings by square examination,P<0.05.Conclusion In patients with lower respiratory tract infections,the serum level of IgE rises.Humoral immunity is relatively increased and cell immunity decreased.So the TH1/TH2 is out of balance.With the treatment of dexamethasone,the body’s immune system is suppressed.In short time,the infection and asthma can be controlled,but TH1/TH2 can’t change after treatment.IFN-γ can interfere the duplication of virus,increase the level of IFN-γ in body,furthermore it can strengthen the cell immune function,lower cell immunologial answer of TH2 and recover the balance of TH1/TH2 The followup suggests IFNγ has an important meaning in preventing infant asthma.
Key wordsLow respiratory tract infections;IFN dexamethasone;Cell immunity;Humoral immunity

关键词: 毛细支气管炎, 干扰素, 地塞米松, 细胞免疫, 体液免疫

Abstract: Abstract Objective To observe the effect of dexamethasone and IFNγ on the function of TH1/TH2 in lower respiratory tract infections.Methods Sixty patients with lower respiratory tract infections were divided randomly into 2 groups:group I with dexamethasone treatment,group II with IFN-γ treatment.Normal group of 15 cases was as control.Serum levels of IgE,IFNγ and IL4 were detected before and after treatment.Results Compared with normal control,there was significant difference in the serum level of IgE,IFN-γ,IL-4,IFN-γ/IL-4 in group Ⅰ and group ,P<0.001.There was no difference in the serum level of IgE,IFNγ,IL4,IFNγ/IL4 between group I and group Ⅱ before treatment(P>0.05).But there was significant difference after treatment(P<0.001).After being followed up for 12 months,3 cases suffered from asthma in group Ⅰ,10 cases in group Ⅱ.There were outstanding meanings by square examination,P<0.05.Conclusion In patients with lower respiratory tract infections,the serum level of IgE rises.Humoral immunity is relatively increased and cell immunity decreased.So the TH1/TH2 is out of balance.With the treatment of dexamethasone,the body’s immune system is suppressed.In short time,the infection and asthma can be controlled,but TH1/TH2 can’t change after treatment.IFN-γ can interfere the duplication of virus,increase the level of IFN-γ in body,furthermore it can strengthen the cell immune function,lower cell immunologial answer of TH2 and recover the balance of TH1/TH2 The followup suggests IFN-γ has an important meaning in preventing infant asthma.

Key words: Humoral immunity , IFN dexamethasone, Cell immunity