梁东阁 张婷 李会娟 何倩倩 黄晗 韩志英

[摘要] 目的 探讨支气管哮喘患儿不同时期血清白介素-17（IL-17）、白介素-27（IL-27）水平的变化及其与肺功能的相关性。 方法 随机选取2018年6月至2019年12月于我院就诊的支气管哮喘患儿共150例（急性发作期50例、慢性持续期50例、临床缓解期50例）作为试验组，另随机选取于我院进行健康体检的健康儿童50名作为对照组。采用酶联免疫吸附法检测所有入组者外周血清IL-17、IL-27浓度，同时对可配合完成肺功能检查者进行肺通气功能检测，并对结果进行分析。 结果 哮喘患儿血清IL-17水平高于对照组，差异有统计学意义（P<0.05）;IL-17水平与肺功能主要指标FEV1、FVC呈负相关。哮喘患儿IL-27水平低于对照组，差异有统计学意义（P<0.05）;IL-27水平与肺功能主要指标FEV1、FVC呈正相关。 结论 血清IL-17、IL-27水平可作为评价儿童支气管哮喘控制水平的参考指标。

[关键词] 白介素-17;白介素-27;肺功能;支气管哮喘

[中图分类号] R725          [文献标识码] B          [文章编号] 1673-9701（2021）34-0063-04

[Abstract] Objective To investigate the changes of serum interleukin-17 （IL-17） and interleukin-27 （IL-27） levels in children with bronchial asthma （BA） at different stages and their correlation with pulmonary function. Methods A total of 150 BA children （50 cases in acute attack stage， 50 cases in chronic duration stage and 50 cases in clinical remission stage） treated in our hospital from June 2018 to December 2019 were randomly selected as the experimental group， and 50 healthy children underwent physical examination in our hospital were randomly selected as the control group. The concentration of IL-17 and IL-27 in peripheral serum of all participants was detected by enzyme-linked immunosorbent assay （ELISA）. Meanwhile， the pulmonary ventilation function of those who can cooperate with pulmonary function examination was detected， and the results were analyzed. Results The serum IL-17 level of children with asthma was higher than that of the control group， and the difference was statistically significant（P<0.05）. The level of IL-17 was negatively correlated with the main indexes of pulmonary function， such as FEV1 and FVC. The level of IL-27 in children with asthma was lower than that in control group， and the difference was statistically significant（P<0.05）. The level of IL-27 was positively correlated with the main indexes of pulmonary function， such as FEV1 and FVC. Conclusion The levels of serum IL-17 and IL-27 can be used as reference indexes to evaluate the control level in BA children.

[Key words] Interleukin-17; Interleukin-27; Pulmonary function; Bronchial asthma

支氣管哮喘简称哮喘，是儿童呼吸内科常见的慢性气道疾病，以反复发作的咳嗽、喘息、胸闷、气促为主要表现，其本质是气道的慢性炎症及可逆性的气流受限[1]。全国儿童哮喘患病率调查提示我国儿童哮喘患病率逐渐升高，不仅影响患儿身心健康，也给患儿家庭及社会带来沉重的医疗负担[2]。哮喘的发病机制目前尚不清楚，经典学说Thl/Th2细胞功能失衡并不能全面解释哮喘的发生。Th17细胞及其标志性细胞因子白介素-17（IL-17）与气道高反应的形成相关，参与哮喘的发生，尤其是重症哮喘[3-5]。近年来研究发现，白介素-27（IL-27）具有免疫抑制作用，有抑制Th17细胞分化的作用，使IL-17的分泌减少，抑制炎症反应[6]。本研究旨在分析不同时期支气管哮喘患儿外周血IL-17和IL-27水平变化的意义，探讨其与肺功能的相关性，寻求哮喘诊断与预后评估的新指标，为临床诊疗提供一定依据，现报道如下。……