| Objective:Asthmatic disease is a kind of allergic disease,it is associated with the respiratory tract infection.According to the survey the incidence of wheezing is rising year by year.Wheezing outbreak,There's a high probability that repeatedly wheezing outbreak will lead to asthma.A study found out that about 70% of patients with asthma have the first wheezing outbreak before the age of 3.For wheezing patients,Early intervention and treatment can prevent further development,which will reduce the morbidity of asthma.This is a problem that both domestic and foreign scholars are trying to solve.This study was designed to investigate the changes of serum IL-4,IL-12,IL-37,25-(OH)D in ? 3-year-old group who have once wheezing attack,in ?3-year-old group who have wheezing attack many times(including three times),in > 3-year-old group who have wheezing attack many times(including three times),and the normal group,to explore the level of IL-4,IL-12,IL-37 and 25-(OH)D associated with asthmatic disease,to observe the relationship between the pathogenesis of asthma and wheeze,provide a theoretical basis for the early prevention and early diagnosis of bronchial asthma.Methods: We randomly selected patients from pediatric inpatients and outpatients of the N0.2 Hospital of Hebei Medical University from November2015 to November 2016.Except the children whose wheezing caused by congenital heart disease,gastroesophageal reflux,bronchial foreign body,bronchopulmonary dysplasia and the vitamin D interveners,in additional never use a glucocorticoid and immune inhibitors in the last 2 weeks.There were a total of 72 cases,including 20 cases who have once wheezing attack in? 3-year-old group,18 cases who have wheezing attack many times in ?3-year-old group,and 34 cases who have wheezing attack many times in >3-year-old group.Select 16 cases of normal children from our pediatric physical examination service as the control group.There was no statistical difference in gender among the four groups(P>0.05),and we had obtained the informed consent from all enrolled children' parents.After extracting and centrifugating serum specimens from four groups of children's peripheral venous blood,the serum specimens were frozen in-70? refrigerator.To detect the concentration of IL-4,IL-12,IL-37 and 25-(OH)D.All experimental data were analyzed by the SPSS17.0 statistical software.Results:1 Level of serum IL-4: In ? 3-year-old group who have once wheezing attack,in ? 3-year-old group who have wheezing attack many times,in >3-year-old group who have wheezing attack many times,and the normal group,the level of serum IL-4 were: 21.06±2.93pg/ml,23.88±3.91pg/ml,25.85±4.02pg/ml,17.74±1.77pg/ml,respectively.The results showed: The serum level of IL-4 in the group who have once wheezing attack and in the group who have wheezing attack many times were higher than the normal control group,there was statistically significant difference(P<0.001);The serum level of IL-4 in ? 3-year-old group who have wheezing attack many times was higher than the ? 3-year-old group who have once wheezing attack,there was statistically significant difference(P<0.001);The serum level of IL-4,who have wheezing attack many times in ? 3-year-old group compared with the > 3-year-old group,there was no statistically significant difference(P>0.05).2 Level of serum IL-12: In ? 3-year-old group who have once wheezing attack,in ? 3-year-old group who have wheezing attack many times,in >3-year-old group who have wheezing attack many times,and the normal group,the level of serum IL-12 were: 30.68±3.65pg/ml,23.24±3.72pg/ml,22.60±2.24 pg/ml,33.35±2.40pg/ml,respectively.The results showed: The serum level of IL-12 in the group who have once wheezing attack and in the group who have wheezing attack many times were lower than the normalcontrol group,there was statistically significant difference(P<0.001);Serum level of IL-12 in ? 3-year-old group who have wheezing attack many times was lower than the ? 3-year-old group who have once wheezing attack,there was statistically significant difference(P=0.018);The serum level of IL-12,who have wheezing attack many times in ? 3–year-old group compared with the > 3-year-old group,there was no statistically significant difference(P>0.05).3 Level of serum IL-37: In ? 3-year-old group who have once wheezing attack,in ? 3-year-old group who have wheezing attack many times,in >3-year-old group who have wheezing attack many times,and the normal group,the level of serum IL-37 were: 21.55±2.01pg/ml,17.14±2.05pg/ml,17.74±2.82 pg/ml,24.52±2.32pg/ml,respectively.The results showed: The serum level of IL-37 in the group who have once wheezing attack and in the group who have wheezing attack many times were lower than the normal control group,there was statistically significant difference(P<0.001);Serum level of IL-37 in ? 3-year-old group who have wheezing attack many times was lower than the ? 3-year-old group who have once wheezing attack,there was statistically significant difference(P<0.001);The serum level of IL-37,who have wheezing attack many times in ? 3-year-old group compared with the > 3-year-old group,there was no statistically significant difference(P>0.05).4 Level of serum 25-(OH)D: In ? 3-year-old group who have once wheezing attack,in ? 3-year-old group who have wheezing attack many times,in > 3-year-old group who have wheezing attack many times,and the normal group,the level of serum 25-(OH)D were: 17.31±3.41ng/ml,15.25±3.08ng/ml,12.60±3.64ng/ml,33.41±5.89ng/ml,respectively.The results showed: The serum level of 25-(OH)D in the group who have once wheezing attack and in the group who have wheezing attack many times were lower than the normal control group,there was statistically significant difference(P<0.001);Serum level of 25-(OH)D who have wheezing attack many times in > 3-year-old group,was lower than the ? 3-year-old groupwho have wheezing attack many times,there was statistically significant difference(P=0.026);In ? 3-year-old group who have once wheezing attack,compared with the ? 3-year-old group who have wheezing attack many times,there was no statistically significant difference(P>0.05).5 The serum IL-37 level was positive correlated with the serum IL-12,25-(OH)D level,and negatively correlated with the serum IL-4 level in children with asthmatic disease.The serum 25-(OH)D,IL-12,IL-37 level positive correlated,and the serum 25-(OH)D,IL-4 level negatively correlated.The serum IL-12,IL-4 level negatively correlated.Conclusion:1 The level of serum level of IL-4 rise,show the Th2 cells overactive,the level of serum IL-12,IL-37 are reduced,show the Th1 cells underactive,account for the imbalances of Th1/Th2 is exist in the body of the wheezing children;2 Low serum Vitamin D levels,was positive correlated with the serum IL-12,IL-37,and negatively correlated with the serum IL-4 level in children with asthmatic disease.Probably work as a precipitating factor for asthmatic diseases.Therefore,in the clinical treatment,the supplement of Vitamin D should be pay attention. |
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