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7、患儿外周血T淋巴细胞亚群、IL-5、IL-25水平变化及其与ACT评分的相关性研究罗婷婷，胡梦娇，赵静利，程雨嘉，李青宝鸡市人民医院儿科，陕西宝鸡721000【摘要】目的观察哮喘患儿外周血T淋巴细胞亚群、白介素-5(IL-5)、白介素-25(IL-25)水平，并分析其与哮喘控制测试评分表(ACT)评分的关系。方法选取2017年5月至2020年6月宝鸡市人民医院收治的115例哮喘患儿作为观察组，依据患儿的临床表现分为缓解期组47例与急性发作期组68例，另选取同期在我院体检的50例健康儿童为对照组，检测两组儿童外周血T淋巴细胞亚群(CD3+、CD4+、CD8+、CD4+/CD8+)、IL-5及IL
8、-25水平，采取ACT问卷调查患儿哮喘控制情况，并使用Pearson相关性检验法分析患儿T淋巴细胞亚群、IL-5、IL-25水平与ACT评分相关性。结果急性发作期组患儿的CD8+为(37.025.24)%，明显低于缓解期组的(40.196.23)%和对照组的(43.055.03)%，缓解期组又明显低于对照组，差异均有统计学意义(P0.05)；急性发作期组患儿的CD4+、CD4+/CD8+分别为(54.787.06)%、1.570.28，明显高于缓解期组(51.167.75)%、1.400.25和对照组(47.615.02)%、1.180.17，缓解期组又明显高于对照组，差异均有统计学意义(P0
9、.05)；急性发作期组患儿的IL-5、IL-25分别为(74.9212.13)pg/mL、(57.248.96)pg/mL，明显高于缓解期组(67.3810.54)pg/mL、(48.738.05)pg/mL和对照组(50.869.85)pg/mL、(44.687.12)pg/mL，缓解期组又明显高于对照组，差异均有统计学意义(P0.05)；急性发作期组患儿的ACT评分为(16.152.76)分，明显低于缓解期组的(20.842.37)分，差异有统计学意义(P0.05)；经Pearson相关性分析结果显示，CD8+与ACT评分呈显著正相关(P0.05)，CD4+、CD4+/CD8+、IL-5、
10、IL-25与ACT评分呈显著负相关(P0.05)，具有可比性。哮喘患儿依据临床表现分为缓解期组47例和急性发作期组68例。本研究经我院医学伦理委员会批注。1.2方法(1)检测方法：抽取对照组儿童入院检查时、观察组入院后空腹静脉血5 mL，采取3 000 r/min速率予以离心处理，取血清。通过八色流式细胞仪(型号：MACSQuant，购自德国Miltenyi Biotec)完成T淋巴细胞亚群(CD3+、CD4+、CD8+、CD4+/CD8+)的检测。通过Thermo Multiskan MK3酶标仪，使用酶联免疫吸附试验双抗体夹心法进行IL-5与IL-25水平检测，相关试剂盒来自美国R&D公司
11、，严格依据说明书完成操作过程。(2)采取哮喘控制测试评分表(ACT)7评估患儿哮喘控制情况，总分25分，控制良好：25分；基本控制：2024分；未得到控制：20分。1.3观察指标比较缓解期组、急性发作期组与对照组儿童外周血T淋巴细胞亚群(CD3+、CD4+、CD8+、CD4+/CD8+)、IL-5、IL-25水平；比较缓解期组、急性发作期组儿童ACT评分。1.4统计学方法应用 SPSS22.0统计软件分析数据。计数资料组间比较采用2检验；计量资料符合正态分布，以均数标准差(x-s)表示，组间两两比较采用独立样本t检验，多组比较采用单因素方差分析法，多组两两比较采用LSD-t检验法；采取Pear
12、son相MethodsA total of 115 asthma children admitted to Baoji Peoples Hospital from May 2017 to June 2020 were selectedas the observation group,which were divided into the remission stage group(n=47)and the acute attack group(n=68)ac-cording to clinical manifestations.In addition,50 healthy children w
13、ho were examined during the same period were select-ed as the control group.The levels of peripheral blood T lymphocyte subsets(CD3+,CD4+,CD8+and CD4+/CD8+),IL-5,and IL-25 in the two groups were detected.The situation of asthma control in children was investigated by ACT.The cor-relation of T lympho
14、cyte subsets,IL-5,and IL-25 levels with ACT score was analyzed by Pearson method.ResultsThelevel of CD8+in the acute attack group was(37.025.24)%,which was significantly lower than(40.196.23)%in the re-mission stage group and(43.055.03)%in the control group,and the levels in the remission stage grou
15、p was significant-ly lower than that in the control group(P0.05).The levels of CD4+and CD4+/CD8+in the acute attack group were(54.787.06)%and 1.570.28,which was significnatly higher than(51.167.75)%,1.400.25 in the remission stage groupand(47.615.02)%,1.180.17 in the control group,and the levels in
16、the remission stage group were significantly higherthan in the control group(P0.05).The levels of IL-5 and IL-25 in the acute attack group were(74.9212.13)pg/mL and(57.248.96)pg/mL,which were significantly higher than(67.3810.54)pg/mL,(48.738.05)pg/mL in the remissionstage group and(50.869.85)pg/mL,(44.687.12)pg/mL in the control group,and the levels in the remission groupwere significantly higher than those in the control group(P0.05).The ACT score in the acute attack group was(16.152.76)points