摘要
目的测定哮喘产妇组的新生儿脐血中IL-5、IL-18、IL-10、TNF-α的水平,并与正常产妇组进行对照,研究四者在两组间的差别及四者之间的相关关系,探讨测定IL-5、IL-18、IL-10、TNF-α水平及IL-10四者联合检测在哮喘发病早期检测和预防中的意义。
方法哮喘产妇组30例,正常对照组40例,分别采集两组新生儿脐血各5 ml,离心血液,分离血清,分装成一次用量,-20℃冰箱冻存待检,应用酶联免疫吸附法(ELISA)分别测定各组血清中IL-5、IL-18、IL-10、TNF-α的浓度,并应用SPSS13.0软件进行统计分析,两组间比较采用t检验,IL-5、IL-18、IL-10、TNF-α两两之间进行双变量相关性分析,采用Pearson相关系数,以P<0.05为有统计学意义。
结果1.哮喘产妇组的新生儿脐带血IL-18浓度(564.17±470.15ng/L)明显高于对照组(197.11±96.09ng/L),差异有统计学意义(P<0.01)；脐带血IL-5水平在两组间没有差异(P>0.05),但哮喘产妇组平均浓度(144.9249±93.53ng/L)高于对照组(110.435±75.98 ng/L)；哮喘产妇组脐带血IL-10(20.43±7.86 ng/L)水平明显低于正常产妇组(30.505±9.564 ng/L),差异有统计学意义(P<0.01)；TNF-α水平哮喘产妇组(118.49±19.98 ng/L)显著高于正常对照组(82.33±7.27ng/L),差异有统计学意义(P<0.01)。
2.对哮喘产妇组新生儿脐血中IL-10、IL-18、IL-5、TNF-α四个因子进行两两之间的双变量相关性分析可见,IL-10与TNF-α之间的呈负相关关系,相关系数r=-0.409,P=0.025,有统计学意义；IL-5与IL-10也呈负相关关系,相关系数r=-0.812,P=0.009,有统计学意义；TNF-α与IL-5的相关系数r=0.343,P=0.051,相关系数无统计学意义；IL-18与IL-5、IL-10、TNF-α水平之间均无明显相关关系,相关系数分别为-0.102,0.034,0.066,P值均大于0.05。结论1.阳性哮喘家族史是哮喘发病的重要危险因素,对有高危因素的新生儿进行哮喘的早期检测和预防具有重要的临床意义；
2.哮喘组产妇新生儿脐血中IL-18、TNF-α、IL-10与正常对照组有明显差别、IL-5虽无统计学差别,但哮喘产妇组均值水平高于对照组,表明IL-5、IL-18、IL-10、TNF-α均参与了哮喘的发病,对脐血中这四个因子的检测分析对于哮喘早期诊断和预防具有临床意义。
3.脐血中IL-18、IL-5、IL-10、TNF-α的相关性分析发现IL-10与TNF-α、IL-10与IL-5之间呈相关关系,对IL-10、TNF-α、IL-5三个因子进行联合检测将有助于增加早期诊断哮喘的可能性和准确性。
Objective To measure the levels of IL-18、IL-5、TNF-α、IL-10 in cord blood from neonates of the mothers normal or with asthma and do correlation analysis, evaluate their clinical value in early detection of asthma.
Methods Umbilical cord blood was collected from 30 asthmatic lying-in women and 40 healthy lying-in women.Every sample is about 5ml,deal it with a centrifuge, collect the serum and repack it,then storage in-20℃. Serum samples were assayed for IL-18、IL-5、TNF-α、IL-10 using commercial enzyme-linked immunosorbent assay (ELISA).The data was analyzed with SPSS13.0 for t test and Bivariate correlation.it has significant difference when P<0.05.
Result 1.IL-18 serum level of neonates with asthmatic mothers (564.17±470.15ng/L) was significantly higher than that of the control group (197.11±96.09ng/L) (P<0.01),so does TNF-αwhose serum level is 118.49±19.98 ng/L (P<0.01).The serum IL-5 is higher in neonates of the mothers with asthma (144.9249±93.53ng/L),but the differences were not statistically significant; IL-10 was significantly decreased in the neonates of asthmatic mothers (20.43±7.86 ng/L),while the control group is 30.505±9.564 ng/L
2.TNF-αand IL-10 is correlated, r=-0.409,P=0.025, so does the IL-10 and IL-5,with r=-0.812 and P=0.009.and we also do correlation test between IL-5 and TNF-α, r=0.343,P=0.051,but it was not significant. There was not significant correlation between IL-18 and the other three factors,the related coefficient is-0.102,0.034,0.066,P>0.05.
Conclusion 1.Positive family history is an important risk factor for asthma,neonates with this should be given early examine.
2.There are significant differences between neonates with asthmatic mothers and their control group of IL-18、TNF-α、IL-10.Although the difference of IL-5 is not significant,the level of IL-5 is higher in asthmatic group. So it has guided meaning of measuring IL-18、IL-5、TNF-α、IL-10 in umbilical cord blood for these neonates who are prone to be affected by asthma.
3.we demonstrate that there is correlation among IL-5、TNF-α、IL-10,examine these three factors at the same time will improve the early diagnosis rate.
引文
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