幽门螺杆菌感染对慢性荨麻疹患者外周血γ-干扰素和白细胞介素-4的调控机制

doi:10.3877/cma.j.issn.1674-1358.2017.05.016

目的

探讨并发幽门螺杆菌感染的慢性荨麻疹患者外周血γ-干扰素（IFN-γ）和白细胞介素-4（IL-4）的调控机制。

方法

随机选取2014年7月至2015年5月于本院就诊且具有较为典型临床表现的慢性荨麻疹患者共70例，选择同期于本院体检的50例健康人为对照组；筛选抗-Hp阴性和抗-Hp阳性患者，采用ELISA法检测其外周血IFN-γ和IL-4水平。

结果

慢性荨麻疹患者与对照组患者抗-Hp阳性率存在较大差异；对照组患者中抗-Hp阳性和抗-Hp阴性者IFN-γ水平差异无统计学意义。慢性荨麻疹患者组中抗-Hp阳性患者IFN-γ和IL-4水平分别为（298.74 ± 35.46）pg/ml和（251.31 ± 29.98）pg/ml，低于抗-Hp阴性患者的（322.45 ± 50.02）pg/ml和（214.45 ± 51.01）pg/ml，差异均具有统计学意义（t = 1.734、P = 0.034，t = 3.569、P = 0.028）；慢性荨麻疹患者IFN-γ及IL-4水平为（122.74 ± 81.36）pg/ml和（297.12 ± 79.14）pg/ml，对照组患者分别为（89.46 ± 34.56）pg/ml和（1 512.12 ± 151.24）pg/ml，差异具有统计学意义（t = 2.374、P = 0.016，t = 1.072、P = 0.034）。

结论

幽门螺杆菌感染对慢性荨麻疹患者外周血单个核细胞产生IFN-γ和IL-4具有调控作用，可以导致Th细胞亚群失衡，进而导致患者免疫功能异常程度加重。

关键词: 幽门螺杆菌, 慢性荨麻疹, γ-干扰素, 白细胞介素-4

Objective

To investigate the regulatory mechanism of interferon gamma and interleukin-4 in peripheral blood of patients with chronic urticaria complicated by Helicobacter pylori infection.

Methods

Total of 70 patients with typical clinical manifestations of chronic urticaria from July 2014 to May 2015 in our hospital were selected, randomly. While 50 healthy people were collected in the same period as control group. The levels of IFN-γand IL-4 were detected by ELISA after screening of patients with anti-Hp negative and anti-Hp positive.

Results

The anti-Hp positive rate of patients with chronic urticaria were significantly different from that in the control group. The levels of IFN-γ between anti-Hp positive and anti-Hp negative in patients of the control group were with no significant differences. The levels of IFN-γ and IL-4 in anti-Hp positive patients with chronic urticaria were (298.74 ± 35.46) pg/ml and (251.31 ± 29.98) pg/ml, respectively, significantly lower than those in anti-Hp negative patients, which were (322.45 ± 50.02) pg/ml and (214.45 ± 51.01) pg/ml (t = 1.734, P = 0.034; t = 3.569, P = 0.028). The levels of IFN-γ and IL-4 in patients with chronic urticaria were (122.74 ± 81.36) pg/ml and (297.12 ± 79.14) pg/ml, significantly higher than those in the control group, whiche were (89.46 ± 34.56) pg/ml and (1512.12 ± 151.24) pg/ml, with significant differences (t = 2.374, P = 0.016; t = 1.072, P = 0.034).

Conclusions

IFN-γ and IL-4 could regulate the activity of chronic urticaria in peripheral blood mononuclear cells of patients with Hp infection, and could cause the imbalance of Th cell subsets, which leading to the immune function of patients with abnormal severity.

Key words: Helicobacter pylori, Chronic urticaria, Interferon gamma, Interleukin-4

表1 对照组与荨麻疹患者组血清IL-4和IFN-γ的水平（ ± s，pg/ml）

组别	例数	IFN-γ	IL-4
对照组	30	1512.12 ± 151.24	89.46 ± 34.56
荨麻疹患者组	40	297.12 ± 79.14	122.74 ± 81.36
t值		-2.210	26.450
P值		0.017	0.016

表1 对照组与荨麻疹患者组血清IL-4和IFN-γ的水平（ ± s，pg/ml）

组别	例数	IFN-γ	IL-4
对照组	30	1512.12 ± 151.24	89.46 ± 34.56
荨麻疹患者组	40	297.12 ± 79.14	122.74 ± 81.36
t值		-2.210	26.450
P值		0.017	0.016

表2 慢性荨麻疹患者抗-Hp阳性与抗-Hp阴性患者血清IL-4和IFN-γ的水平（ ± s）

组别	例数	IFN-γ（pg/ml）	IL-4（pg/ml）
抗-Hp阳性组	20	298.74 ± 35.46	251.31 ± 29.98
抗-Hp阴性组	20	322.45 ± 50.02	214.45 ± 51.01
t值		-1.120	-2.150
P值		0.034	0.028

表2 慢性荨麻疹患者抗-Hp阳性与抗-Hp阴性患者血清IL-4和IFN-γ的水平（ ± s）

组别	例数	IFN-γ（pg/ml）	IL-4（pg/ml）
抗-Hp阳性组	20	298.74 ± 35.46	251.31 ± 29.98
抗-Hp阴性组	20	322.45 ± 50.02	214.45 ± 51.01
t值		-1.120	-2.150
P值		0.034	0.028

表3 对照组患者中抗-Hp阳性的与抗-Hp阴性者血清IL-4和IFN-γ的水平（ ± s）

组别	例数	IFN-γ（pg/ml）	IL-4（pg/ml）
抗-Hp阳性者	15	345.33 ± 52.01	22.45 ± 5.12
抗-Hp阴性者	15	341.51 ± 49.12	19.65 ± 8.41
t值		-0.180	-2.210
P值		0.033	0.028

表3 对照组患者中抗-Hp阳性的与抗-Hp阴性者血清IL-4和IFN-γ的水平（ ± s）

组别	例数	IFN-γ（pg/ml）	IL-4（pg/ml）
抗-Hp阳性者	15	345.33 ± 52.01	22.45 ± 5.12
抗-Hp阴性者	15	341.51 ± 49.12	19.65 ± 8.41
t值		-0.180	-2.210
P值		0.033	0.028

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Regulatory mechanism of Helicobacter pylori infection on peripheral interferon gamma and interleukin-4 in peripheral blood of patients with chronic urticaria

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Regulatory mechanism of Helicobacter pylori infection on peripheral interferon gamma and interleukin-4 in peripheral blood of patients with chronic urticaria