海南医科大学学报

目的:探讨血清1,25二羟基维生素D3(1,25D3)、T淋巴细胞亚群(Th1/Th2)及免疫球蛋白(IgE)水平与儿童应变性鼻炎(AR)的关系及其相互作用机制。方法:应用高效液相色谱串联质谱(HPLC-MS/MS)仪测定125例AR患儿、120例非应变性鼻炎(NAR)患儿及120例正常体检儿童(对照组)血清1,25D3水平,ELISA法测定三组外周血Th1类细胞因子(IL-2、IFN-γ)、Th2类细胞因子(IL-4、IL-10)及血清IgE水平。采用Pearson相关因素分析1,25D3与T淋巴细胞亚群及IgE的关系。将AR患儿随机分为糖皮质激素治疗组(A组)及联合维生素D治疗组(B组),对比分析两组治疗前后1,25D3、T淋巴细胞亚群及IgE水平变化。结果:AR组血清1,25D3、IL-2、IFN-γ明显低于NAR组及正常组,而IL-4、IL-10、IgE水平明显高于NAR组及正常组,差异具有统计意义(P<0.05);NAR组与对照组相比,差异无统计学意义(P>0.05)。经Pearson相关因素分析可知,1,25D3与IL-2、IFN-γ呈正相关,而与IL-4、IL-10、IgE水平呈负相关(P<0.05)。B组患儿治疗后1,25D3、IL-2、IFN-γ高于A组,而IL-4、IL-10、IgE水平低于A组,差异均具有统计学意义(P<0.05)。结论:1,25D3缺乏或不足与儿童应变性鼻炎具有密切的关系,其可能作用机制为1,25D3缺乏可导致机体Th1/Th2细胞因子分泌失衡,刺激IgE水平升高引起变态反应。

Objective:To investigate the relationship between levels of serum 1,25-dihydroxyvitamin D3(1,25D3),T lymphocyte subsets(Th1/Th2),immunoglobulin(IgE)and allergic rhinitis(AR)in children.Methods:The levels of serum levels 1,25D3 was determined by HPLC-MS/MS,Th1cytokines(IL-2,IFN-γ),Th2cytokines(IL-4,IL-10)and serum IgE were determined by ELISA assay in 120 cases of non-allergic rhinitis(NAR group)and 120 normal children(control group).The relationship of 1,25D3 of T lymphocyte subsets and IgE were analyzed with pearson correlation factor.AR children were divided into glucocorticoid therapy group(group A)and combined with vitamin D therapy group(group B),The levels of 1,25D3,T lymphocyte subsets and IgE of two groups were compared.Results:The levels of serum 1,25D3,IL-2,IFN-γof AR groups were significantly lower than NAR group and control group,while the levels of IL-4,IL-10,IgE were significantly higher than NAR group and the control group(P<0.05).There was no significant difference between NAR group and controlgroup(P>0.05).The levels of 1,25D3 were positively correlated with IL-2,and IFN-γand were negatively correlated with IL-4,IL-10,IgE(P<0.05).The levels of 1,25D3,IL-2,IFN-γof group B were significantly higher than those in group A(P<0.05),whereas the levels of IL-4,IL-10,IgE were significantly lower than those in group A(P<0.05).Conclusion:Lack of or inadequate 1,25D3 has closely correlation with allergic rhinitis.1,25D3 deficiency lead to Th1/Th2 cytokine imbalance,then stimulate elevated levels of IgE,which cause allergy stimulation.