哮喘儿童血清细胞因子水平及布拉氏酵母菌干预的研究

目的:探讨布拉氏酵母菌对儿童哮喘血清细胞因子水平的影响。方法: 将184例哮喘患儿随机分为对照组（常规治疗）90例,观察组（布拉氏酵母菌）94例。两组均按GINA方案治疗。观察组联合布拉氏酵母菌1.0/次，每日2次口服，连用4周。采用ELISA法检测治疗前3组（另设健康组80例）及治疗后2组（观察组和对照组）外周血白介素-10（IL-10）、白介素-17（IL-17）、白介素-5（IL-5）、干扰素-γ（IFN-γ）水平。观察其临床疗效、血清细胞因子及肺功能变化。结果:观察组总有效率(91.49％)明显高于对照组(72.22％)，差异有统计学意义(P<0.01)。治疗前两组血清中IL-17、IL-5水平均高于健康组及IL-10、IFN-γ水平低于健康组；治疗后两组IL-17、IL-5均下降（P<0.01,P<0.05 ），IFN-γ、IL-10上升（P<0.01,P<0.05 ），但观察组上升或下降幅度明显优于对照组(P<0.01)，治疗后组间比较,差异具有统计学意义（P<0.01）。治疗后两组肺功能均有改善，但观察组改善程度明显高于对照组(P<0.01)。 结论:哮喘患儿外周血IL-10、IFN-γ与IL-17、IL-5浓度成负相关。布拉氏酵母菌能有效治疗儿童哮喘，其机制可能与调节Thl/Th2细胞因子的偏移有关。

Study on asthmatic children serum cytokine levels and saccharomyces boulardii intervention

AIM: To investigate the serum cytokine levels in children with asthma and saccharomyces boulardii intervention. METHODS: 184 cases of children with asthma were randomly divided with routine treatment (90 cases) and observation group with saccharomyces boulardii intervention (94 cases). Two groups were treated with GINA regimen. The observation group received another saccharomyces boulardii 1.0/ times, 2 times a day orally for 4 weeks. The IL-10, IL-17, IL-5 and IFN-γ in peripheral blood of 3 groups (the third group includes another 80 healthy cases) before treatment and 2 groups (observation group and control group) after treatment were detected by ELISA method. The clinical effect, serum cytokine and lung function were observed. RESULTS: The total effective rate of the observation group (91.49%) was significantly higher than that of the control group (72.22%) (P<0.01). Levels of IL-17 and IL-5 before treatment in two groups were higher than those of the healthy group and Levels of IL-10 and IFN-γ were lower than those in the healthy group. After treatment, levels of IL-17 and IL-5 in two groups decreased (P<0.01 or P<0.05）, levels of IL-10 and IFN- γ increased (P<0.01or P<0.05) , but the observation group increased or decreased significantly better than the control group (P<0.01). After treatment, the lung function of the two groups were improved, but the improvement degree of the observation group was significantly higher than that of the control group (P<0.01). CONCLUSION: Levels of IL-10 and IFN- γ in peripheral blood from children with asthma are negatively correlated with the concentrations of IL-17, IL-5. Saccharomyces boulardii can be effective in treating asthma in children, the mechanism may be related to the migration of Thl/Th2 cytokines.