小儿支原体肺炎中医证候与TH细胞相关性研究

摘要

目的 探讨TH1、TH2、TH17的效应因子干扰素-Y(IFN-γ)、白细胞介素(IL)-4、IL-17与小儿肺炎支原体肺炎(MPP)中医证型的关系.方法 选取55例MPP住院患儿,根据症状体征进行中医辨证分型,检测血清IFN-γ、IL-4,IL-17含量,与33例正常组儿童进行比较.结果 55例MPP中,风热闭肺证25例,痰热闭肺证3例,痰瘀互阻证11例,脾虚痰蕴证16例.MPP患儿血清IFN-v、IL-4、IL-17较正常组儿童均升高,IL-4、IL-17显著升高(均P<0.01),IFN-γ升高无统计学意义.痰热闭肺证的血清IFN-γ,IL-4含量均高于其余3组(P<0.01);脾虚痰蕴证IL-4低于其余3组(P<0.01):IL-17含量各证型之间差异无统计学意义.结论 MPP患儿中医证候与TH细胞具有相关性,可为不同证型分期论治提供较客观的免疫学指标.%Objective To study TCM syndromes characteristic of mycoplasma pneumoniae pneumonia (MPP) and explore its relationship with TH1, TH2, TH17 cells' effect factors IFN-γ, IL-4, IL-17. Method Fifty-five cases of MPP hospitalized children, detemined TCM syndrome differentiation according to symptoms and signs, were detected serum levels of IFN-γ, IL-4, IL-17, with 33 normal children as normal control group. Results In 55 cases, there were 25 cases of the wind-heat blocking the lung syndrome, 3 cases of the phlegm-heat blocking the lung syndrome, 11 cases of the binding of phlegm and blood stasis syndrome, 16 cases of the phlegm accumulate due to spleen deficiency syndrome. Serum IFN-γ, IL-4,IL-17 level increased in MPP patients compared with control group, with significant difference in IL-4 and IL-17 (P＜0.01), while no difference in IFN-γ level. Serum levels of IFN-γ and IL-4 in syndrome of phlegm-heat blocking the lung were higher than the other three syndromes significantly (P＜0.01). Serum level of IL-4 in syndrome of phlegm accumulate due to spleen deficiency was lower than the other three syndromes significantly (P＜0.01). There was no difference in IL-17 levels among the various syndromes.Conclusion The TCM syndrome and TH cells of MPP children have relativity, which provides more objective immunology index sign for the MPP clinical treatment based on syndrome differentiation.