| Objective:This study with2to3years of clinical follow-up, was designed to investigatethe change of serum Interleukin-4(IL-4), Interferon-γ（INF-γ）and urinary LeukotrieneE4(LTE4) in acute exacerbation and convalescence of infants with asthmatic diseasesby early detection, at the same time, combining with Asthma Predictive Index (API)for analysis, to explore the role of serum IL-4，INF-γ and urinary LTE4in infants withpersistent wheezing. This study may provide the basis of correct diagnosis, effectiveintervention and treatment for infants with asthmatic diseases.Methods:Select63infants with asthmatic diseases(asthmatic group) and22healthyinfants(control group) in pediatric outpation department of our hospital and thehospitalization. Serum level of IL-4, INF-γ and urine level of LTE4were measured byenzyme linked immunosorbent assay(ELISA). The allergens in the serum were alsodetected. The results were analyzed by SPSS17.0．By telephone contact and follow-up examinationg from pediatric outpation, thefollow-up observation begined from Jan.2011to Dec.2013. Make records refering topositive API values. There were28infants(wheezing group) with persistent wheezingand32infants(non-wheezing group) with non-wheezing after the age of3years.Change of IL-4, INF-γ, IL-4/INF－γ ratio and LTE4between wheezing groupand non-wheezing group were dectected. Positive stringent API scores, the positiverate of intervention and allergen were also analysed with statistically.Results:1. Duing to changing address or wrong phone number,3cases were lost.60cases compeleted the follow-up, including28infants(wheezing group) with persistentwheezing and32infants(non-wheezing group) with non-wheezing at the age of3years. No statistical significance was found（P＞0.05） after comparing their gender,age, frequency of asthma attack, WBC, CRP and MP. The eosinophilia of wheezinggroup were more than that of non-wheezing group（P＜0.01）. 2. The levels of serum IL-4in acute asthma period was higher than that of acutenon-wheezing and normal control group（P＜0.05）；In remission/convalescence,thelevels of serum IL-4were lower than that of acute period(P＜0.01), but were stillhigher than that of non-wheezing and normal control group(P＜0.01).3. The levels of serum INF-γ in acute asthma period was lower than that of acutenon-wheezing and normal control group(P＜0.01)；In remission/convalescence, thelevels of serum INF-γ were significantly higher than that of acute period(P＜0.01),but were still lower than that of non-wheezing during remission period and normalcontrol group(P＜0.01), neither were not significantly different from normal controlgroup during remission period（P＞0.05）.4. The levels of serum IL-4/INF-γ in acute asthma period was higher than that ofacute non-wheezing and normal control group；In remission/convalescence, the levelsof serum IL-4/INF-γ were lower than that of acute period(P＜0.01), but were stillhigher than that of non-wheezing and normal control group(P<0.01).5. The levels of urinary LTE4in acute asthma period were higher than normalcontrol group（P＜0.01）, but were not significantly different between wheezing groupand non-wheezing group（P＞0.05）；In remission/convalescence, the levels of urinaryLTE4was ower than that of acute period(P＜0.01), but was still higher than that ofnormal control group(P<0.01).6. The positive stringent API scores were significantly higher than non-wheezing group(P＜0.01).7. With a positive rate of32.14%, dust mites were the severe allergen. Thepositive rate of allergens were higher than that of non-wheezing group（P<0.05）, butthat of the food allergens of the two groups had no significant differences（P>0.05）.8. Compared with non-wheezing group, wheezing group had frequent asthmaattack（P<0.01）.9. The rate of intervention were higher than non-wheezing group（P<0.01）.Conclusion:1. Serum IL-4, INF-γ and urinary LTE4might contribute to the mechanism ofasthmatic diseases.2. Concentration of serum IL-4and urinary LTE4maintained a high level. Especially the imbalance of serum IL-4/INF-γ ratio might be one of the factors thatled to persistent wheezing after the age of3years. They might be used as earlyidentification of the infants or preschool children with tendency to persistentwheezing(asthma).3. The infants with a high level of serum IL-4, urinary LTE4and serum IL-4/INF-γ ratio maintained, should take the prevention of asthma by early intervention, ifthey begin with atopic-associated life, especially positive inhalant allergens，eosinophilia or positive stringent API scores. |
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